4A (Expenses $ 194821295 including grants of $ 383525) (Revenue $ 210827972)
INPATIENT (SEE SCHEDULE O)

4B (Expenses $ 141548439 including grants of $ 0) (Revenue $ 153178174)
OUTPATIENT (SEE SCHEDULE O)

4C (Expenses $ 27767907 including grants of $ 0) (Revenue $ 30049341)
EMERGENCY DEPT. (SEE SCHEDULE O)

4D (Expenses $ 0 including grants of $ 0) (Revenue $ 11179156)
SEE SCHEDULE O

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSNORTHEAST HOSPITAL CORPORATION AFFILIATIONNORTHEAST HOSPITAL CORPORATION (NHC OR HOSPITAL) IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATE, AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.NORTHEAST HOSPITAL CORPORATION COMMUNITY BENEFITS MISSION STATEMENT NORTHEAST HOSPITAL CORPORATION (NHC OR HOSPITAL) D/B/A BEVERLY HOSPITAL, ADDITION GILBERT HOSPITAL AND BAYRIDGE HOSPITAL IS A MEMBER OF BETH ISRAEL LAHEY HEALTH (BILH). BILH BELIEVES THAT EVERYONE DESERVES HIGH - QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES BILH TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES IT SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIESNORTHEAST HOSPITAL CORPORATION'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING NHC'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE HOSPITAL'S THREE-YEAR IMPLEMENTATION STRATEGY. ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT NHC'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES. ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED NEEDS AND IDENTIFY COMMUNITIES AND POPULATION SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC, AND SYSTEMIC FACTORS. IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN NHC'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED. PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDITION GILBERT HOSPITAL AND BAYRIDGE HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $4,534,136 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE NORTHEAST HOSPITAL CORPORATION BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. WORLD-CLASS CLINICAL EXPERTISE, EDUCATION, AND RESEARCH ALONG WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY ARE THE PRIMARY TENETS OF ITS MISSION. NHC'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF NHC'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF NHC'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. NHC'S COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE DIRECTOR OF COMMUNITY BENEFITS. THE DIRECTOR OF COMMUNITY BENEFITS HAS DIRECT ACCESS AND IS ACCOUNTABLE TO NHC'S PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, THE LATTER OF WHOM REPORTS DIRECTLY TO THE BILH CHIEF DIVERSITY, EQUITY, AND INCLUSION OFFICER. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE NHC COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH NHC'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT NHC'S COMMUNITY BENEFITS MISSION TO REDUCE BARRIERS TO HEALTH CARE AND TO CONTINUALLY STRIVE TO REDUCE HEALTH DISPARITIES AND HEALTH INEQUITIES FOR THOSE WHO ARE MOST VULNERABLE IN OUR COMMUNITY. NHC SEEKS TO IDENTIFY CURRENT AND EMERGING HEALTH NEEDS AND ADDRESS THESE NEEDS THROUGH EDUCATION, PREVENTION, TREATMENT, AND THE PROMOTION OF HEALTHY BEHAVIORS.THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF NHC'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF NHC'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF NHC'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY NHC'S PROGRAMMATIC ENDEAVORS, INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION, AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. NHC COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) MEMBERS: NANCY PALMER, CBAC BOARD CHAIR, NORTHEAST HOSPITAL CORPORATION BOARD OF TRUSTEES TOM SANDS, PRESIDENT, BEVERLY, AND ADDISON GILBERT HOSPITALS MARYLOU HARDY, REGIONAL MANAGER COMMUNITY RELATIONS/COMMUNITY BENEFITS, NHC CHRISTINE HEALEY, DIRECTOR, COMMUNITY RELATIONS/COMMUNITY BENEFITS, BILH JASON ANDREE, VICE PRESIDENT, BEVERLY, AND ADDISON GILBERT HOSPITALS ANDREW DEFRANZA, EXECUTIVE DIRECTOR, HARBORLIGHT COMMUNITY PARTNERS DAVID DICHIARA, MD, ASSOCIATE CHIEF MEDICAL OFFICER, BEVERLY/ADDISON GILBERT HOSPITAL DUTROCHET DJOKO, CHAIR OF HUMAN RIGHTS & INCLUSION COMMITTEE, DANVERS BOARD OF HEALTH CINDY DONALDSON, RESIDENT, BEVERLY/ADDISON GILBERT HOSPITAL MARK GENDREAU, MD, CHIEF MEDICAL OFFICER, BEVERLY/ADDISON GILBERT HOSPITAL PEGGY HEGARTY-STECK, PRESIDENT & EXECUTIVE DIRECTOR, ACTION, INC. BRIAN HOLMES, MEDICAL ASSISTANT EDUCATOR, BETH ISRAEL LAHEY HEALTH PRIMARY CARE ROBERT IRWIN, TRUSTEE, NORTHEAST HOSPITAL CORPORATION BOARD OF TRUSTEES JULIE LAFONTAINE, PRESIDENT AND CEO, THE OPEN DOOR CHRIS LOVASCO, PRESIDENT, YMCA OF THE NORTH SHORE WHITNEY MCNEILLY, DIRECTOR, DANVERSCARES CHESSYE MOSELEY, TRUSTEE, NHC BOARD OF TRUSTEES KAREN NEVA BELL, TRUSTEE, NHC BOARD OF TRUSTEES VALERIE PARKER CALLAHAN, DIRECTOR, GREATER LYNN SENIOR SERVICES JONATHAN PAYSON, TRUSTEE, NHC BOARD OF TRUSTEES KIMBERLY PERRYMAN, CHIEF NURSING OFFICER, BEVERLY/ADDISON GILBERT HOSPITAL MIKE TARMEY, VICE PRESIDENT, BAYRIDGE HOSPITAL ABU TOPPIN, DIVERSITY, EQUITY, AND INCLUSION DIRECTOR, CITY OF BEVERLY SCOTT TRENTI, CHIEF EXECUTIVE OFFICER, SENIORCARE CAROLINA TRUJILLO, TRUSTEE, NHC BOARD OF TRUSTEESCOMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R)

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS WITH THE NHC COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. IDENTIFY NHC'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE NHC'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY NHC DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE: YOUTH AND ADOLESCENTS OLDER ADULTS LOW-RESOURCE INDIVIDUALS AND FAMILIES RACIALLY AND ETHNICALLY DIVERSE POPULATIONS AND NON-ENGLISH SPEAKERSNHC'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY. HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM NHC'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023; SEPTEMBER 30, 2024; AND SEPTEMBER 30, 2025. PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFITS ACTIVITIES REPORTED IN THIS FORM 990 SCHEDULE HAS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDITION GILBERT HOSPITAL AND BAYRIDGE HOSPITAL MOST RECENTLY COMPLETED CHNA WAS COMPLETED DURING THE FISCAL YEAR ENDED 2022 AND THE FIRST YEAR OF ACCOMPLISHMENTS UNDER THAT CHNA AND IMPLEMENTATION STRATEGY (IS) WILL BE REPORTED IN THE FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2023. THE PRIOR CHNA AND CHIP PROCESS WHICH WAS COMPLETED BY NHC IN 2019 INFORMED THE COMMUNITY BENEFITS OPERATIONS AND ACCOMPLISHMENTS REPORTED IN THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS DESCRIBED IN DETAIL BELOW. 2019 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONNHC COMPLETED ITS 2019 ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHICAL FOCUS OF NHC'S 2019 CHNA ENCOMPASSES THE FOLLOWING CITIES AND TOWNS: BEVERLY, DANVERS, ESSEX, GLOUCESTER, IPSWICH, LYNN, MANCHESTER BY-THE-SEA, MIDDLETON, AND ROCKPORT.TARGET POPULATIONS FOR NHC'S COMMUNITY BENEFITS INITIATIVES WERE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).NHC'S TARGET POPULATIONS FOCUSED ON MEDICALLY UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES WITH A FOCUS ON: INDIVIDUALS AND FAMILIES OF LOW RESOURCE CHILDREN AND FAMILIES OLDER ADULTS INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE 2019 CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS QUALITATIVE INFORMATION OBTAINED FROM 41 INTERVIEWS WITH INTERNAL CLINICAL STAFF AND HOSPITAL LEADERS, 4 FOCUS GROUPS, # COMMUNITY SURVEYS, AND 2 COMMUNITY LISTENING SESSIONS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE 9 CITIES AND TOWNS IN NHC'S CBSA (BEVERLY, DANVERS, ESSEX, GLOUCESTER, IPSWICH, LYNN, MANCHESTER BY-THE-SEA, MIDDLETON, AND ROCKPORT) WITH A RANGE OF PEOPLE REPRESENTING DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., OLDER ADULTS, YOUTH, LOW RESOURCED INDIVIDUALS, ETC.) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 1,000 PEOPLE. APPENDIX A IN THE NORTHEAST HOSPITAL CORPORATION CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.THE ASSESSMENT BEGAN IN 2018 WITH THE CREATION OF A STEERING COMMITTEE COMPOSED OF REPRESENTATIVES FROM THE FORMER LAHEY HEALTH SYSTEM, INCLUDING NHC, WINCHESTER HOSPITAL, AND LAHEY HOSPITAL AND MEDICAL CENTER. THE HOSPITAL HIRED JSI, A PUBLIC HEALTH RESEARCH AND CONSULTING FIRM IN BOSTON, TO COMPLETE THE CHNA AND IMPLEMENTATION STRATEGY. THE STEERING COMMITTEE PROVIDED VITAL OVERSIGHT OF THE CHNA APPROACH, METHODS, AND REPORTING PROCESS.

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
NHC ENGAGED ITS CBAC, MADE UP OF HOSPITAL LEADERSHIP AND CLINICAL STAFF, LOCAL SERVICE PROVIDERS, AND KEY COMMUNITY STAKEHOLDERS, EXTENSIVELY THROUGHOUT THIS PROCESS. THIS GROUP MET THREE TIMES OVER THE COURSE OF THE ASSESSMENT AND PROVIDED INPUT ON THE ASSESSMENT APPROACH, VETTED PRELIMINARY FINDINGS, AND HELPED PRIORITIZE COMMUNITY HEALTH ISSUES AND VULNERABLE POPULATIONS. THE CBAC ALSO REVIEWED AND PROVIDED FEEDBACK ON THE ASSOCIATED IMPLEMENTATION STRATEGY. IN ADDITION, THE NHC PFAC WAS CONVENED TO PROVIDE INPUT AND FEEDBACK FROM A SYSTEM WIDE PERSPECTIVE. THE PAC WAS COMPOSED OF REPRESENTATIVES FROM CLINICAL AND ADMINISTRATIVE LEADERSHIP AND LOCAL PUBLIC HEALTH OFFICIALS, ALONG WITH COMMUNITY RELATIONS STAFF. THE PAC MET THREE TIMES OVER THE COURSE OF THE PROJECT, PROVIDED BROAD - BASED FEEDBACK ON THE APPROACH, AND VETTED PRELIMINARY FINDINGS RELATIVE TO PRIORITY COMMUNITY HEALTH ISSUES AND VULNERABLE POPULATIONS. QUANTITATIVE DATA: QUANTITATIVE DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN NHC'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF THE HEALTH - RELATED ISSUES. SOURCES INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY YEAR ESTIMATES (2013 - 2017) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017 AND 2018 - 2019) FBI UNIFORM CRIME REPORTS (2017) MDPH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) MDPH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) MDPH, ANNUAL REPORTS ON BIRTHS (2016) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY13 - 17) MASSACHUSETTS CHIA HOSPITAL DISCHARGES (2017) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018) YOUTH RISK BEHAVIOR SURVEYS (2017 AND 2018)TO AUGMENT THE QUANTITATIVE DATA FROM MDPH, JSI WORKED WITH THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) TO OBTAIN 2018 INPATIENT HOSPITAL DISCHARGE DATA FOR ALL OF THE MUNICIPALITIES IN THE SERVICE AREA.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - KEY INFORMANT INTERVIEWS (SCHEDULE H, PART V, SECTION B, LINE 5)NHC, WITH THE HELP OF JOHN SNOW, INC., CONDUCTED 41 KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS, INCLUDING REPRESENTATIVES FROM HOSPITAL AND MUNICIPAL LEADERSHIP, THE BUSINESS COMMUNITY, PUBLIC HEALTH DEPARTMENTS, SOCIAL SERVICE PROVIDERS, SCHOOLS, AND COMMUNITY HEALTH COALITIONS. JSI ALSO FACILITATED THREE FOCUS GROUPS. APPENDIX A IN THE NHC CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)THREE FOCUS GROUPS AND THREE LISTENING SESSIONS WERE CONDUCTED WITH IDENTIFIED UNDERSERVED POPULATIONS WERE ALSO HELD. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE CITY AND TOWNS THAT COMPRISE THE NORTHEAST HOSPITAL CORPORATION REGION. PARTICIPANTS REPRESENTED DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., YOUTH, SENIORS, MINORITY GROUPS AND FOREIGN - LANGUAGE SPEAKERS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 1000 PEOPLE. APPENDIX A IN THE NORTHEAST HOSPITAL CORPORATION CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSTHE FINAL PHASE OF THE CHNA PROCESS INCLUDED THE FOLLOWING STEPS: REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS. IDENTIFY NHC'S COMMUNITY BENEFITS PRIORITY POPULATIONS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE NHC'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2016 CHNA AND SUBSEQUENT IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY NHC DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015). DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018).2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSNORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDITION GILBERT HOSPITAL AND BAYRIDGE HOSPITAL'S CHNA WAS COMPLETED IN SEPTEMBER 2019, AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS), WAS DEVELOPED TO ADDRESS THE KEY FINDINGS AND INFORM NHC'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020, SEPTEMBER 30, 2021, AND SEPTEMBER 30, 2022. THE IS WAS DEVELOPED BY A TEAM COMPRISED OF HOSPITAL LEADERSHIP, MEDICAL STAFF, COMMUNITY BENEFITS STAFF, AND COMMUNITY REPRESENTATION. THE GROUP REVIEWED PROGRESS TOWARD GOALS AND OBJECTIVES OF THE PRIOR THREE - YEAR PERIOD, AS WELL AS THE CURRENT DATA COLLECTED THROUGH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. LISTED BELOW IS A HIGH-LEVEL SUMMARY OF THE PRIORITY AREAS IDENTIFIED AFTER A COMPREHENSIVE REVIEW OF ALL THE QUANTITATIVE AND QUALITATIVE INFORMATION THAT WAS COLLECTED. AN IN-DEPTH DISCUSSION OF THE FINDINGS IS INCLUDED IN THE FULL CHNA REPORT.1. SOCIAL DETERMINANTS OF HEALTH. THE SOCIAL DETERMINANTS OF HEALTH (E.G., TRANSPORTATION, ECONOMIC STABILITY, ACCESS TO CARE, HOUSING, AND FOOD INSECURITY) AFFECT MANY SEGMENTS OF THE POPULATION. A KEY THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND COMMUNITY HEALTH SURVEY WAS THE CONTINUED IMPACT THAT THE SOCIAL DETERMINANTS OF HEALTH HAVE ON RESIDENTS OF NHC CBSA, ESPECIALLY THOSE WHO ARE LOW TO MODERATE INCOME, FRAIL OR HOMEBOUND, HAVE MENTAL HEALTH OR SUBSTANCE USE ISSUES, OR LACK A CLOSE SUPPORT SYSTEM. 2. ACCESS TO CARE. CERTAIN POPULATIONS ARE MORE VULNERABLE TO HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE ENROLLMENT AND THE COMMUNITIES THAT MAKE UP LHMC/LMCP'S SERVICE AREA HAVE STRONG, ROBUST SAFETY NET SYSTEMS, THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW - INCOME, MEDICAID - COVERED, UNINSURED, AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND BEHAVIORAL SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND BEHAVIORAL HEALTH SERVICES.3. MENTAL HEALTH. MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY/STRESS, ACCESS TO TREATMENT, STIGMA) UNDERLIE MANY HEALTH AND SOCIAL CONCERNS. NEARLY EVERY KEY INFORMANT INTERVIEW, FOCUS GROUP, AND LISTENING SESSION INCLUDED DISCUSSIONS ON THE IMPACT OF MENTAL HEALTH ISSUES. FROM A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION, DEPRESSION, ANXIETY/STRESS, AND SOCIAL ISOLATION WERE THE LEADING CONCERNS. THERE WERE PARTICULAR CONCERNS ABOUT THE IMPACT OF DEPRESSION, ANXIETY, AND E - CIGARETTE/VAPING ON YOUTH AND SOCIAL ISOLATION AMONG OLDER ADULTS. 4. SUBSTANCE DEPENDENCY. SUBSTANCE DEPENDENCY CONTINUES TO AFFECT INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE OPIOID EPIDEMIC CONTINUES TO BE AN AREA OF FOCUS. BEYOND OPIOIDS, KEY INFORMANTS WERE ALSO CONCERNED WITH ALCOHOL MISUSE, CHANGING COMMUNITY NORMS IN LIGHT OF THE LEGALIZATION OF RECREATIONAL MARIJUANA USE, AND E - CIGARETTE/VAPING AMONG ADOLESCENTS. 5. CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS. CHRONIC DISEASES (E.G., CARDIOVASCULAR DISEASE, CANCER, DIABETES, ASTHMA) REQUIRE MORE EDUCATION, SCREENING/EARLY INTERVENTION, AND MANAGEMENT AND A FOCUS ON RISK FACTORS. ALTHOUGH THERE WAS MAJOR EMPHASIS ON BEHAVIORAL HEALTH ISSUES, MANY KEY INFORMANTS, FOCUS GROUP PARTICIPANTS, AND LISTENING SESSION PARTICIPANTS IDENTIFIED A NEED TO ADDRESS THE MANY RISK FACTORS ASSOCIATED WITH CHRONIC AND COMPLEX HEALTH CONDITIONS. PHYSICAL INACTIVITY AND POOR NUTRITION/LIFESTYLE WERE DISCUSSED BY MANY, WITH SOME OF THESE ISSUES BEING ASSOCIATED WITH AGE (MOBILITY ISSUES AMONG OLDER ADULTS), EDUCATION/HEALTH LITERACY (LACK OF UNDERSTANDING ABOUT HEALTHY EATING), AND SOCIOECONOMIC STATUS (FRESH FOODS BEING EXPENSIVE, AND GYMS AND HEALTH CENTERS UNAFFORDABLE). ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF MANY CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGIES.

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
INTERIM CHANGES AND UPDATES TO 2019 IMPLEMENTATION STRATEGY BASED ON NEWLY IDENTIFIED COMMUNITY NEEDS COVID PANDEMICAS PREVIOUSLY NOTED IN THIS FILING, IRC SECTION 501(R)(3) AND THE PROMULGATED REGULATIONS REQUIRE THAT A TAX-EXEMPT HOSPITAL CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY ADDRESSING COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AT LEAST ONCE EVERY THREE YEARS. THE PREAMBLE TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R)(3) NOTES THAT THE TREASURY AND THE IRS INTENDED FOR THE CHNA AND IMPLEMENTATION STRATEGY REQUIREMENT TO ESTABLISH CONTINUAL FEEDBACK ON CHNA REPORTS AND A HOSPITAL IS REQUIRED TO CONSIDER COMMENTS RECEIVED RELATED TO THE EXISTING CHNA AND IMPLEMENTATION STRATEGY WHEN ENGAGING IN THE NEXT CHNA PROCESS NOT MORE THAN THREE YEARS AFTER ADOPTION. IN ADDITION, FINAL REGULATIONS DO NOT PROHIBIT IMPLEMENTATION STRATEGIES FROM DISCUSSING HEALTH NEEDS IDENTIFIED THROUGH MEANS OTHER THAN A CHNA, PROVIDED THAT THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE ALSO DISCUSSED. FINALLY, THERE IS NOTHING IN THE REGULATIONS THAT PROHIBITS A HOSPITAL FROM UPDATING ITS IMPLEMENTATION STRATEGY BASED ON AN OFF CYCLE CHANGE TO THE COMMUNITY HEALTH NEEDS THAT ARISE. DURING THE FY20 FISCAL PERIOD (OCTOBER 1, 2019 - SEPTEMBER 30, 2020), THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY NHC, WERE IMPACTED BY AN UNEXPECTED GLOBAL PANDEMIC. ON JANUARY 9, 2020, THE WORLD HEALTH ORGANIZATION (WHO) ANNOUNCED THE IDENTIFICATION OF A NEW AND NOVEL CORONAVIRUS-RELATED PNEUMONIA IN WUHAN, CHINA. ON JANUARY 21, 2020, THE UNITED STATES CENTER FOR DISEASE CONTROL CONFIRMED THE FIRST CASE OF THIS NEW CORONA VIRUS IN THE UNITED STATES. ON JANUARY 31, 2020, THE WHO ISSUED A GLOBAL HEALTH EMERGENCY AND ON FEBRUARY 3 THE UNITED STATES DECLARED A PUBLIC HEALTH EMERGENCY BECAUSE OF THE COVID-19 VIRUS. ON MARCH 11, 2020, THE WHO DECLARED COVID-19 A PANDEMIC AND TWO DAYS LATER, THE PRESIDENT OF THE UNITED STATES DECLARED COVID-19 A NATIONAL EMERGENCY. THE HEALTH OF THE COMMUNITIES SERVED BY NHC WERE IMPACTED BY THIS UNFORESEEN HEALTH CRISIS AND IN THE ABSENCE OF REGULATORY GUIDANCE TO THE CONTRARY, NHC NEEDED TO QUICKLY REASSESS AND PIVOT TO MEET THE NEW AND PREVIOUSLY UNEXPECTED COMMUNITY NEEDS. AS SUCH, IN RESPONSE TO THE COVID-19 CRISIS NHC'S COMMUNITY BENEFITS STAFF ALONG WITH THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND IN RESPONSE TO COVID, EXPANDED GOALS RELATED TO ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH TARGETED PRIMARILY AT LOW INCOME AND MINORITY POPULATIONS WHO HAVE BEEN DISPROPORTIONATELY IMPACTED BY COVID-19. NHC DEDICATED A GREAT DEAL OF TIME AND RESOURCES AT THE LOCAL LEVEL IN RESPONSE TO THE COVID-19 GLOBAL PANDEMIC. NHC WAS INTENTIONAL WHEN ASSESSING RISK FACTORS WITHIN OUR CBSA AND WORKED CLOSELY WITH LOCAL HEALTH DEPARTMENTS. CLINICAL STAFF PROVIDED INFECTION CONTROL EXPERTISE TO LOCAL HEALTH DEPARTMENTS DURING THEIR REOPENING PLANS. NHC WORKED TO EXPAND COMMUNITY TESTING ACCESS AND WORKED WITH BILH AS A SYSTEM TO DEVELOP AND DISTRIBUTE WRITTEN MATERIALS (IN NINE LANGUAGES) TO THE COMMUNITIES MOST IMPACTED BY COVID-19, TO HELP SLOW THE SPREAD. NHC REDEPLOYED STAFF AND PROCURED TANGIBLE NECESSITIES FOR BOTH THE COMMUNITY AT LARGE AND HOSPITAL STAFF, SUCH AS PERSONAL PROTECTIVE EQUIPMENT (PPE), FOOD, HAND SANITIZER, AND OTHER CRITICAL ITEMS. IN ADDITION, MANY OF THE COMMUNITY BENEFITS PROGRAMS HAD TO BE MODIFIED SIGNIFICANTLY DUE TO COVID-19 AND RELATED SAFETY GUIDELINES. IN SOME CASES, PROGRAMS WERE EXPANDED. IN OTHERS, PROGRAMS WERE CUT OR SIGNIFICANTLY REDUCED BECAUSE OF THE PANDEMIC. THE ACTIONS TAKEN TOWARD ADDRESSING THESE NEEDS ARE INCLUDED FURTHER IN THIS NARRATIVE SUPPORT ALONG WITH NHC'S DETAILED DESCRIPTION OF ACTIVITIES UNDERTAKEN TO MEET THE COMMUNITY NEEDS. COMMUNITY HEALTH NEEDS ASSESSMENTMAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLENHC STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, NHC COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE NHC WEBSITE AT: BEVERLY AND ADDISON GILBERT HOSPITALS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (BEVERLYHOSPITAL.ORG)IN ADDITION TO THE CHNA, NHC COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE NHC WEBSITE AT: BEVERLY & ADDISON GILBERT HOSPITALS 2023-2025 IMPLEMENTATION STRATEGY (BEVERLYHOSPITAL.ORG)IN ADDITION, AS NOTED ABOVE, NHC COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE NHC WEBSITE AT: 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (BEVERLYHOSPITAL.ORG)FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING NHC'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE NHC WEBSITE AT: BEVERLY HOSPITAL & ADDISON GILBERT HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (LAHEY.ORG)THESE DOCUMENTS ARE ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, NHC'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, BUT IT IS THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY WHICH INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF NHC FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, WHICH ARE REPORTED HERE. A SUMMARY OF NHC'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE 2019 CHNA, COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, NHC HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, BH-AGH HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS: MENTAL HEALTH SUBSTANCE DEPENDENCY CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARECOMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)NHC HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES NHC OPERATED AND SUPPORTED TO IMPROVE HEALTH OUTCOMES AMONG THEIR TARGET POPULATIONS THROUGHOUT THEIR CBSA.NHC ALSO CONTINUED TO DEDICATE SIGNIFICANT TIME AND RESOURCES TO RESPOND TO NEEDS RELATED TO COVID-19, SUCH AS FOOD INSECURITY, HOUSING INSTABILITY, AND ACCESS TO CARE. FY22 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEKEY: BASELINE-2020, YEAR 1-2021, YEAR 2-2022PRIORITY AREA #1 - MENTAL HEALTH:MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY/STRESS, ACCESS TO TREATMENT, STIGMA) UNDERLIE MANY HEALTH AND SOCIAL CONCERNS. NEARLY EVERY KEY INFORMANT INTERVIEW, FOCUS GROUP, AND LISTENING SESSION INCLUDED DISCUSSIONS ON THE IMPACT OF MENTAL HEALTH ISSUES. FROM A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION, DEPRESSION, ANXIETY/STRESS, AND SOCIAL ISOLATION WERE THE LEADING CONCERNS. THERE WERE PARTICULAR CONCERNS ABOUT THE IMPACT OF DEPRESSION, ANXIETY, AND VAPING ON YOUTH AND SOCIAL ISOLATION AMONG OLDER ADULTS. GOAL: SUPPORT MENTAL HEALTH OUTREACH, EDUCATION, AND PREVENTION PROGRAMS, AND IMPROVE ACCESS TO TREATMENT AND SERVICES.TARGET POPULATION: INDIVIDUALS AND FAMILIES OF LOW RESOURCE, OLDER ADULTS, CHILDREN AND FAMILIES, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES:1.1 INCREASE THE NUMBER OF INDIVIDUALS AND FAMILIES EDUCATED ON THE RISKS, PROTECTIVE FACTORS, AND IMPACTS OF MENTAL HEALTH ISSUES.1.2 INCREASE THE NUMBER OF INDIVIDUALS WHO ARE SCREENED AND REFERRED TO APPROPRIATE MENTAL HEALTH TREATMENT AND SUPPORT SERVICES.1.3 REDUCE STRUCTURAL BARRIERS TO MENTAL HEALTH TREATMENT.INCREASE THE NUMBER OF PRIMARY CARE PRACTICES THAT HAVE INTEGRATED BEHAVIORAL HEALTH SERVICES.1.4 EXPLORE OPPORTUNITIES TO REDUCE SOCIAL ISOLATION AND DEPRESSION.

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
"COMMUNITY ACTIVITIES: SUPPORT THE HIGH-RISK INTERVENTION TEAM SUPPORT COUNSELING AND/OR REFERRAL RESOURCES IN COMMUNITY - BASED SETTINGS SUPPORT BAYRIDGE TRANSPORTATION AND TAXI VOUCHER PROGRAMS ENHANCE AND PROMOTE INTEGRATED BEHAVIORAL HEALTH IN PRIMARY CARE CLINICS ORGANIZE AND SUPPORT INITIATIVES THAT INCREASE OPPORTUNITIES FOR SOCIAL ENGAGEMENT METRICS AND STATUS UPDATE - FY20-FY22: COLLABORATIVE CARE MODEL- NHC IMPLEMENTED THE COLLABORATIVE CARE MODEL, INTEGRATING BEHAVIOR HEALTH CLINICIANS INTO MORE THAN TEN PRIMARY CARE SITES IN THE CBSA. CLINICIANS PROVIDED CONVENIENT ACCESS TO MENTAL HEALTH SERVICES.FY20: 1,523 PATIENTS REACHEDFY21: 1976 PATIENTS REACHEDFY22: 2,120 PATIENTS REACHED THE HIGH RISK INTERVENTION TEAM (HRIT) - A MULTIDISCIPLINARY TEAM WITH PHARMACISTS, SOCIAL WORKERS, RNS, COMMUNITY HEALTH WORKERS, AND RECOVERY COACHES THAT PROVIDES SERVICES TO HIGH RISK CLIENTS TO SUPPORT THEIR COMPLEX NEEDS, INCLUDING BUT NOT LIMITED TO MEDICATION EDUCATION AND PILL BOX SETUP, HOME VISITS, ACCOMPANIMENT TO PCP APPOINTMENTS, ROUNDS IN SKILLED NURSING FACILITIES (SNFS) TO COORDINATE DISCHARGE CARE, ASSISTANCE WITH OBTAINING INSURANCE, ASSISTANCE GETTING NEEDED COMMUNITY AND MENTAL HEALTH SERVICES, ASSISTANCE WITH RECOVERY SERVICES FOR SUBSTANCE USE DISORDERS, ASSISTANCE WITH HOUSING NEEDS, ASSISTANCE OBTAINING FOOD SOURCES, AND ANY AND ALL INTERVENTIONS DESIGNED TO ASSIST PATIENTS TO BE CARED FOR IN THEIR HOMES OR A COMMUNITY SETTING. FY20: 4,716 PATIENTS WERE SERVEDFY21: 5,040 PATIENTS WERE SERVED FY22: 4,860 PATIENTS WERE SERVEDOF ALL THE PATIENTS SERVED, 80% HAD A PUBLIC PAYOR (MEDICARE OR MEDICAID) AND 40% HAD A MENTAL HEALTH DIAGNOSIS OR SUBSTANCE USE DISORDER. BILH BEHAVIORAL SERVICES - PROVIDED INDIVIDUAL AND GROUP MENTAL HEALTH COUNSELING SERVICES IN THE COMMUNITY FOR CHILDREN AND ADULTS WITH MENTAL HEALTH ISSUES. FY20: 194 STUDENTS PARTICIPATED IN SUBSTANCE USE RECOVERY PROGRAMS, 30,783 COUNSELING SESSIONS WERE HELD IN BEVERLY, GLOUCESTER, AND DANVERS REACHING 1580 PEOPLE, AND INTENSIVE CARE COORDINATION AND FAMILY SUPPORT AND TRAINING WAS PROVIDED TO 328 YOUTH MEETING SERIOUS EMOTIONAL DISTURBANCE CRITERIAFY21:194 STUDENTS PARTICIPATED IN SUBSTANCE USE RECOVERY PROGRAMS, 30,783 COUNSELING SESSIONS WERE HELD IN BEVERLY, GLOUCESTER, AND DANVERS REACHING 1580 PEOPLE, AND INTENSIVE CARE COORDINATION AND FAMILY SUPPORT AND TRAINING WAS PROVIDED TO 328 YOUTH MEETING SERIOUS EMOTIONAL DISTURBANCE CRITERIA. FY22: 207 STUDENTS PARTICIPATED IN SUBSTANCE USE RECOVERY PROGRAMS, COUNSELING SESSIONS WERE HELD IN BEVERLY, GLOUCESTER, AND DANVERS REACHING 3,060 PEOPLE, AND INTENSIVE CARE COORDINATION AND FAMILY SUPPORT AND TRAINING WAS PROVIDED TO 305 YOUTH MEETING SERIOUS EMOTIONAL DISTURBANCE CRITERIA. PROJECT UNIPER - NHC AWARDED $27,500 IN FY21, AND $18,000 IN FY22 TO GREATER LYNN SENIOR SERVICES TO SUPPORT PROJECT UNIPER, A PROGRAM WHERE SOFTWARE IS INSTALLED ON A PERSON'S TELEVISION TO PROVIDE VIRTUAL PROGRAMS TO ALLEVIATE SOCIAL ISOLATION AND PROVIDE TOOLS FOR HEALTH MONITORING, HEALTH SELF - MANAGEMENT, AND EDUCATION, AS WELL AS TELEHEALTH VISITS WITH VISITS WITH COUNSELORS. FY21: 50 INDIVIDUALS FROM BEVERLY, IPSWICH, ROCKPORT, MANCHESTER, AND LYNN HAD UNIPER INSTALLED ON THEIR TELEVISIONS AND ACTIVELY PARTICIPATED IN THE PROGRAM. OF THOSE, 40% WERE NON - WHITE, 70% WERE 65 OR OLDER, AND 84% WERE FEMALE. REPORTED OUTCOMES SHOWED THAT ALMOST HALF OF THE PARTICIPANTS USED THE SOFTWARE AT LEAST ONCE PER WEEK, RESULTING IN THE FOLLOWING OUTCOMES: 67% REDUCED THEIR RISK OF FALLING, 37% REDUCED FEELINGS OF LONELINESS, AND 35% REDUCED THEIR LEVEL OF DEPRESSION. FY22: 90 INDIVIDUALS FROM BEVERLY, IPSWICH, ROCKPORT, MANCHESTER, AND LYNN HAD UNIPER INSTALLED ON THEIR TELEVISIONS AND ACTIVELY PARTICIPATED IN THE PROGRAM. OF THOSE, 47% WERE NON - WHITE, 80% WERE 65 OR OLDER, AND 78% WERE FEMALE. REPORTED OUTCOMES SHOWED THAT MORE THAN HALF OF THE PARTICIPANTS USED THE SOFTWARE AT LEAST ONCE PER WEEK, RESULTING IN THE FOLLOWING OUTCOMES: 67% WERE EXERCISING MORE FREQUENTLY, AND 77% REDUCED FEELINGS OF LONELINESS, ISOLATION, AND DEPRESSION. TRANSPORTATION ASSISTANCE - NHC PROVIDED FUNDING FOR STAFFING COSTS AND TAXI VOUCHERS IN ORDER TO PROVIDE FREE TRANSPORTATION TO PATIENTS TRAVELLING TO AND FROM BAYRIDGE HOSPITAL FOR MENTAL HEALTH TREATMENT.FY20: NHC PROVIDED A TOTAL OF $109,768 FOR STAFFING COSTS AND TAXI VOUCHERSFY21: NHC PROVIDED A TOTAL OF $74,863; ($52,850 FOR STAFFING AND $22,103. FOR VOUCHERS).FY22: NHC PROVIDED A TOTAL OF $90,168. ($$53,556. FOR STAFFING AND $36,612 FOR VOUCHERS). NURTURING PARENTS PROGRAM - NHC PROVIDED $18,000 TO PATHWAYS FOR CHILDREN IN FY21 TO IMPLEMENT THE NURTURING PROGRAM, A PROGRAM DESIGNED TO IMPROVE PARENTING SKILLS AND PREVENT CHILD ABUSE AND NEGLECT. FUNDING IN THE AMOUNT OF $18,000 WAS AWARDED AGAIN IN FY22 FOR CONTINUATION OF THE PROGRAM.FY21: THREE SESSIONS WERE HELD IN GLOUCESTER (ONE IN SPANISH) REACHING 60 PEOPLE.FY22: TWO SESSIONS WERE HELD IN BEVERLY (1 IN SPANISH) REACHING 57 PEOPLE. MENTAL HEALTH FIRST AID - NHC AWARDED $10,000 TO SENIORCARE INC. IN FY22 TO IMPLEMENT A MENTAL HEALTH FIRST AID FOR ADULTS PROGRAM. FY22: MORE THAN 30 COMMUNITY MEMBERS COMPLETED FREE MENTAL HEALTH FIRST AID TRAINING ONLINE YRBS - NHC AWARDED $16,200 TO THE CITY OF GLOUCESTER IN FY22 TO DEVELOP AN ONLINE TOOL FOR ADMINISTERING THE YOUTH RISK BEHAVIOR SURVEY (YRBS) FOR GLOUCESTER PUBLIC SCHOOL CHILDREN IN GRADES 6-12. THE GRANT MONEY HELPED DEVELOP AN ONLINE TOOL WHICH NOW PROVIDES FASTER TURNAROUND TIME OF RESULTS/DATA. FY22: IN FY22 DEVELOPMENT OF THE TOOL WAS COMPLETED AND MORE THAN 1,500 STUDENTS COMPLETED THE SURVEY USING THE ONLINE TOOL.PRIORITY AREA 2 - SUBSTANCE DEPENDENCY: SUBSTANCE DEPENDENCY HAS IMPACTS ON INDIVIDUALS, FAMILIES, AND COMMUNITIES. IN NEARLY ALL KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND LISTENING SESSIONS, PARTICIPANTS IDENTIFIED IT AS A MAJOR CONCERN. THE OPIOID EPIDEMIC CONTINUES TO BE AN AREA OF FOCUS, ESPECIALLY IN BH-AGH'S SERVICE AREA, WHERE MANY OF THE COMMONWEALTH'S TREATMENT SERVICES ARE LOCATED. BEYOND OPIOIDS, KEY INFORMANTS WERE ALSO CONCERNED WITH ALCOHOL MISUSE, CHANGING COMMUNITY NORMS IN LIGHT OF THE LEGALIZATION OF RECREATIONAL MARIJUANA USE, AND E-CIGARETTE/VAPING AMONGST ADOLESCENTS. MANY INDIVIDUALS CHARACTERIZED E-CIGARETTE AND VAPING AS AN EPIDEMIC, WITH A NEED FOR EDUCATION, PREVENTION, AND TREATMENT SERVICES. BH-AGH IS COMMITTED TO ADDRESSING THE IMPACT OF SUBSTANCE DEPENDENCY; HOSPITAL STAFF AND LEADERSHIP WILL CONTINUE TO BE LEADERS AND CONVENERS IN PROMOTING COLLABORATION AND SHARING KNOWLEDGE WITH COMMUNITY-BASED PARTNERS. THE HOSPITALS ARE ALSO COMMITTED TO IMPROVING ACCESS TO TREATMENT AND SUPPORT SERVICES THROUGH THEIR COMMUNITY BENEFITS ACTIVITIES.GOALS:#1: ADDRESS THE IMPACT OF SUBSTANCE DEPENDENCY.#2: IMPROVE ACCESS TO SUBSTANCE MISUSE TREATMENT AND SUPPORT SERVICES. TARGET POPULATION: INDIVIDUALS AND FAMILIES OF LOW RESOURCE, OLDER ADULTS, CHILDREN AND FAMILIES, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES:2.1 PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND INCREASE AWARENESS AROUND THE IMPACTS AND RISK FACTORS FOR DEVELOPING SUBSTANCE MISUSE ISSUE.2.2 INCREASE THE NUMBER OF INDIVIDUALS WHO ARE SCREENED AND ARE REFERRED TO APPROPRIATE MENTAL HEALTH TREATMENT AND SUPPORT SERVICES COMMUNITY ACTIVITIES SUPPORT AND/OR PARTICIPATE IN TASK FORCES AND COMMUNITY COLLABORATIONS THAT OFFER EDUCATION ON THE RISKS, PROTECTIVE FACTORS, AND IMPACTS OF SUBSTANCE MISUSE. PROVIDE RECOVERY COACHES IN THE EMERGENCY DEPARTMENTS AT NORTHEAST HOSPITAL CORPORATION; PROVIDE SUBOXONE KITS, MEDICATION - ASSISTED TREATMENT (SHIFT). COMPASS/MOMS DO CARE PROGRAM OFFERING COUNSELING, GROUP THERAPY, AND CONNECTIONS TO SERVICES AND PEER MOMSMETRICS/STATUS UPDATE COMPASS MOMS DO CARE PROGRAM - PROVIDED SUPPORT FOR PREGNANT AND PARENTING WOMEN WITH A HISTORY OF SUBSTANCE USE. IN FY20 THE COVID - 19 PANDEMIC LED TO SUSPENSION OF IN - PERSON GROUPS AND IN - PERSON BEHAVIORAL HEALTH SERVICES. AS A RESULT, THE PROGRAM SUPPORTED WOMEN THROUGH ""PORCH VISITS,"" GROCERY RUNS, FORMULA, AND DIAPER ASSISTANCE, AND ONGOING INDIVIDUAL WORK. PARTICIPANTS REPORTED THEY WERE MORE LIKELY TO INITIATE PRENATAL CARE IN THE FIRST TRIMESTER, ATTEND A POSTPARTUM VISIT, AND INITIATE POSTPARTUM CONTRACEPTION. IN ADDITION, 73% OF ATTENDEES WERE DISCHARGED FROM THE HOSPITAL WITH THE BABY IN THEIR CUSTODY.FY20: PROVIDED SUPPORT FOR 35 WOMENFY21: PROVIDED SUPPORT FOR 40 WOMENFY22: PROVIDED SUPPORT FOR 89 WOMEN, 77 OF WHOM WERE NEW ENROLLEES"

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
HRIT ADDICTION CONSULTS - WITH SUPPORT FROM A GRANT FROM THE NATIONAL INSTITUTE ON DRUG ABUSE, BEVERLY/ADDISON GILBERT HOSPITAL'S HIGH RISK INTERVENTION TEAM (HRIT) PROVIDED ASSISTANCE TO PATIENTS WITH OPIOID USE DISORDER. THE PROGRAM IS A TEAM APPROACH WHERE STAFF FROM THE HRIT WORK TOGETHER WITH MEDICAL STAFF TO PROVIDE INPATIENT ADDICTION CONSULTS, MEDICATION MANAGEMENT, AND ASSISTANCE WITH REFERRALS TO OUTPATIENT RECOVERY AND TREATMENT IN THE COMMUNITY AND/OR WITH RECOVERY COACHES ON THE HRIT. THE MAJORITY OF THOSE SERVED ARRIVED AT THE HOSPITAL FROM ONE OF THE LOCAL DETOX CENTERS OR FROM A LOCAL JAIL OR CORRECTIONAL FACILITY.FY20:140 PATIENTS SERVEDFY21:250 PATIENTS SERVEDFY22: 220 PATIENTS SERVED. MEDICATION DISPOSAL BOX - NHC INVESTED IN A MEDICATION DISPOSAL BOX LOCATED IN THE EMERGENCY DEPARTMENT AT BEVERLY HOSPITAL. THE BOX HELPS COMMUNITY MEMBERS SAFELY DISPOSE OF UNWANTED OR EXPIRED MEDICATIONS TO REMOVE POTENTIALLY DANGEROUS MEDICATIONS FROM THE COMMUNITY AND REDUCE THE RISK OF UNINTENTIONAL USE. MEDICATIONS CAN BE DROPPED OFF 24 HOURS A DAY/7 DAYS A WEEK AND ARE SAFELY DISPOSED OF IN ACCORDANCE WITH DRUG ENFORCEMENT AGENCY REGULATIONS. FY20: 1,400 POUNDS OF UNWANTED MEDICATIONS WERE COLLECTED AND DISPOSED OFFY21: 1,400 POUNDS OF UNWANTED MEDICATIONS WERE COLLECTED AND DISPOSED OFFY22: 1,500 POUNDS OF UNWANTED MEDICATIONS WERE COLLECTED AND DISPOSED OFPRIORITY AREA 3: CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS:HEART DISEASE, STROKE, AND CANCER CONTINUE TO BE THE LEADING CAUSES OF DEATH IN THE NATION AND THE COMMONWEALTH AND PRODUCE A SIGNIFICANT BURDEN ON COMMUNITIES. APPROXIMATELY SIX IN 10 DEATHS CAN BE ATTRIBUTED TO THESE THREE CONDITIONS COMBINED. BY INCLUDING RESPIRATORY DISEASE (E.G., ASTHMA, COPD) AND DIABETES, WHICH ARE IN THE TOP 10 LEADING CAUSES ACROSS ALL GEOGRAPHIES, ONE CAN ACCOUNT FOR THE VAST MAJORITY OF CAUSES OF DEATH. MANY OF THE RISK FACTORS FOR THESE CONDITIONS ARE THE SAME: PHYSICAL INACTIVITY, POOR NUTRITION, OBESITY, AND TOBACCO/ALCOHOL USE. BH-AGH HAS A LONG HISTORY OF WORKING WITH COMMUNITY PARTNERS TO CREATE AWARENESS AND EDUCATION AROUND THESE RISK FACTORS AND THEIR LINKS TO CHRONIC AND COMPLEX HEALTH CONDITIONS. THE HOSPITALS WILL CONTINUE TO SUPPORT PROGRAMS THAT PROVIDE OPPORTUNITIES FOR PEOPLE TO ACCESS LOW-COST HEALTHY FOODS AS WELL AS OPPORTUNITIES FOR SAFE AND AFFORDABLE PHYSICAL ACTIVITY. BEYOND ADDRESSING THE RISK FACTORS, BH-AGH IS ALSO COMMITTED TO SUPPORTING INDIVIDUALS AND CAREGIVERS THROUGHOUT THE SERVICE AREA TO ENGAGE IN CHRONIC DISEASE MANAGEMENT PROGRAMS AND TO USE SUPPORTIVE SERVICES (E.G., INTEGRATIVE THERAPIES, SUPPORT GROUPS), AND CONTINUES TO PROVIDE LINKAGES TO CAREGOAL: PREVENT, DETECT AND MANAGE CHRONIC DISEASE AND COMPLEX CONDITIONS AND ENHANCE ACCESS TO TREATMENT AND SUPPORT SERVICES.TARGET POPULATION: INDIVIDUALS AND FAMILIES OF LOW RESOURCE, OLDER ADULTS, CHILDREN AND FAMILIES, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES: 3.1 CREATE AWARENESS/EDUCATE COMMUNITY MEMBERS ABOUT THE PREVENTABLE RISK FACTORS ASSOCIATED WITH CHRONIC AND COMPLEX HEALTH CONDITIONS.3.2 PROVIDE OPPORTUNITIES FOR PEOPLE TO BE SCREENED FOR CHRONIC AND COMPLEX HEALTH CONDITIONS AND PROVIDE LINKAGES TO ASSOCIATED SERVICES.3.3 SUPPORT INDIVIDUALS AND THEIR CAREGIVERS WHO ARE ENGAGED IN EVIDENCE - BASED SUPPORT AND CHRONIC DISEASE MANAGEMENT PROGRAMS.3.4 INCREASE ACCESS TO AFFORDABLE HEALTHY FOODS AND AFFORDABLE PHYSICAL ACTIVITY.3.5 INCREASE ACCESS TO SUPPORTIVE SERVICES THAT REDUCE STRESS AMONG INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS AND THEIR CAREGIVERS.COMMUNITY ACTIVITIES ORGANIZE AND/OR SUPPORT PROGRAMS THAT PROVIDE ACCESS TO FREE OR LOW - COST HEALTHY FOODS AND PHYSICAL ACTIVITY (E.G., ENHANCE FITNESS, SENIOR NUTRITION PROGRAM, ETC.). PROVIDE SUPPORT TO ALLEVIATE BURDEN(S) ASSOCIATED WITH CHRONIC/COMPLEX CONDITIONS TO INDIVIDUALS AND FAMILY MEMBERS (E.G., SUPPORT GROUPS, CANCER NAVIGATORS, ETC.)METRICS/STATUS UPDATE: BCRA - RECOGNIZING THE RISK FOR BREAST CANCER IS NOT THE SAME FOR ALL WOMEN, NHC PROVIDED FREE RISK ASSESSMENT AT BEVERLY AND ADDISON GILBERT HOSPITALS USING A TABLET SCREENING TOOL TO HELP WOMEN EVALUATE THEIR LIFETIME RISK FOR BREAST CANCER. RESULTS FROM THE ASSESSMENT ARE SHARED WITH THE PERSON'S PHYSICIAN, ARE REVIEWED IN A FOLLOW UP CONSULTATION TO DETERMINE IF THEY MIGHT BENEFIT FROM A HIGHER LEVEL OF SCREENING BEYOND REGULAR CHECKUPS AND MAMMOGRAMS. FY20: CONDUCTED 3,262 FREE SCREENINGS, IDENTIFYING 533 WOMEN WITH A HIGH LIFETIME RISK FOR DEVELOPING BREAST CANCER. FY21: CONDUCTED 3089 FREE SCREENINGS, IDENTIFYING 312 WOMEN WITH A HIGH LIFETIME RISK OF DEVELOPING BREAST CANCER. FY22: CONDUCTED 3,767 FREE SCREENINGS, IDENTIFYING 710 WOMEN WITH A HIGH LIFETIME RISK OF DEVELOPING BREAST CANCER. ONCOLOGY NURSE NAVIGATORS ONCOLOGY NURSE NAVIGATORS AT NORTHEAST HOSPITAL CORPORATION SUPPORT PATIENTS BY CONNECTING THEM WITH COMMUNITY RESOURCES, INCLUDING HEALTH CARE AND SUPPORT SERVICES AND ASSISTING THEM IN THE TRANSITION FROM ACTIVE TREATMENT TO SURVIVORSHIP. FY20: 823 PATIENTS WERE SERVEDFY21:823 PATIENTS WERE SERVEDFY22: 900 PATIENTS WERE SERVED ENHANCE FITNESS - NORTHEAST HOSPITAL CORPORATION PARTNERED WITH THE NORTH SHORE YMCA TO OFFER FREE ENHANCE FITNESS CLASSES TO HELP PARTICIPANTS IMPROVE OVERALL HEALTH AND INCREASE THEIR PHYSICAL ABILITY AND ACTIVITY LEVEL. DUE TO COVID RESTRICTIONS, THE PARTICIPATION RATE WAS LOWER IN FY21 DUE TO COVID RESTRICTIONS.FY20: 249 COMMUNITY MEMBERS PARTICIPATED IN THE PROGRAMFY21:60 COMMUNITY MEMBERS PARTICIPATED IN THE PROGRAM FY22: 68 COMMUNITY MEMBERS PARTICIPATED IN THE PROGRAM HOME BLOOD DRAWS - THE MOBILE PHLEBOTOMY TEAM FROM THE NHC LABORATORY PERFORMED FREE HOMEBOUND LAB VISITS TO PATIENTS WHO WERE HOMEBOUND DUE TO ILLNESS OR TRANSPORTATION ISSUES. PATIENTS SERVED REPORTED INCREASED ACCESS AS WELL AS REDUCED FEELINGS OF ISOLATION BECAUSE THE VISIT WITH THE PHLEBOTOMIST PROVIDED THEM WITH A SOCIAL OPPORTUNITY. FY20: 5,411 HOME BLOOD DRAWS PERFORMED FY21: 5,761 HOME BLOOD DRAWS PERFORMED FY22:4,196 HOME BLOOD DRAWS PERFORMEDPRIORITY AREA 4: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE A DOMINANT THEME FROM THE ASSESSMENT WAS THE TREMENDOUS IMPACT THAT THE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY INCOME/EMPLOYMENT, HOUSING, TRANSPORTATION, AND FOOD INSECURITY, HAVE ON RESIDENTS WITHIN BH-AGH'S CBSA. THE SOCIAL DETERMINANTS OF HEALTH ARE OFTEN THE DRIVERS OR UNDERLYING FACTORS THAT CREATE OR EXACERBATE MENTAL HEALTH ISSUES, SUBSTANCE MISUSE, AND CHRONIC/COMPLEX CONDITIONS. THESE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY INCOME/EMPLOYMENT, ALSO UNDERLIE MANY OF THE ACCESS-TO-CARE ISSUES THAT WERE PRIORITIZED IN THE ASSESSMENT, INCLUDING NAVIGATING THE HEALTH SYSTEM (INCLUDING HEALTH INSURANCE), MANAGING CHRONIC DISEASE, AND AFFORDING CARE. NHC IS COMMITTED TO ADDRESSING SOCIAL DETERMINANTS AND BREAKING DOWN BARRIERS TO CARE BY COLLABORATING WITH COMMUNITY-BASED ORGANIZATIONS TO ENGAGE INDIVIDUALS IN SERVICES, REDUCE FINANCIAL BURDENS, INCREASE ACCESS TO APPROPRIATE PRIMARY AND SPECIALTY CARE SERVICES, AND SUPPORT HEALTHY FAMILIES AND COMMUNITIES. TARGET POPULATION: INDIVIDUALS AND FAMILIES OF LOW RESOURCE, OLDER ADULTS, CHILDREN AND FAMILIES, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES:4.1 EDUCATE PROVIDERS/COMMUNITY MEMBERS ABOUT HOSPITAL OR PUBLIC ASSISTANCE PROGRAMS TO HELP THEM IDENTIFY/ENROLL IN APPROPRIATE HEALTH INSURANCE PLANS AND/OR REDUCE THEIR FINANCIAL BURDEN.4.2 INCREASE ACCESS TO APPROPRIATE PRIMARY CARE AND SPECIALTY CARE SERVICES.4.3 INCREASE ACCESS TO AFFORDABLE AND NUTRITIOUS FOODS.4.4 INCREASE MENTORSHIP, TRAINING, AND EMPLOYMENT OPPORTUNITIES.4.5 INCREASE AWARENESS ABOUT CREATING A HEALTHY AND SAFE ENVIRONMENT FOR BABIES AND FAMILIES AND PROMOTE HEALTHY CHILD DEVELOPMENT.4.6 INCREASE ACCESS TO AFFORDABLE AND FREE OPPORTUNITIES FOR PHYSICAL ACTIVITY.COMMUNITY ACTIVITIES: PROVIDE COUNSELING, SUPPORT, AND REFERRAL SERVICES TO COMMUNITY MEMBERS TO ENROLL AND REMAIN IN APPROPRIATE PROGRAMS (E.G., FINANCIAL COUNSELING, SHINE PROGRAM). SUPPORT PROGRAMS THAT PROVIDE CLINICAL SERVICES IN COMMUNITY - BASED SETTINGS (E.G., HEALTH CENTER AT GLOUCESTER HIGH SCHOOL, MOBILE PHLEBOTOMY). PROVIDE GRANTS TO COMMUNITY PARTNERS TO ADDRESS ISSUES ASSOCIATED WITH FOOD INSECURITY. EXPLORE EMPLOYMENT AND WORKFORCE DEVELOPMENT ISSUES, INCLUDING EXISTING COMMUNITY RESOURCES AND PROGRAMS. IDENTIFY OPPORTUNITIES TO STRENGTHEN THE WORKFORCE, INCLUDING EDUCATION AND JOB TRAINING. ORGANIZE AND/OR SUPPORT PROGRAMS THAT PROMOTE A HEALTHY AND SAFE ENVIRONMENT AND/OR FOSTER HEALTHY DEVELOPMENT AND GROWTH OF INFANTS AND CHILDREN (I.E., CONNECTING YOUNG MOMS, PARENTING EDUCATION, ETC.).

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
"METRICS/STATUS UPDATE:MEDICALLY TAILORED GROCERIES PROGRAM NHC PROVIDED $25K PER YEAR FROM FY20-FY22 TO THE OPEN DOOR TO PROVIDE THE MTG PROGRAM FOR FOOD INSECURE, LOW-RESOURCED INDIVIDUALS AND FAMILIES LIVING IN GLOUCESTER AND SURROUNDING CITIES/TOWNS. THE PROGRAM IS MANAGED BY A REGISTERED DIETITIAN WHO PROVIDES NUTRITION COUNSELING AND EDUCATION SESSIONS FOR THOSE WHO HAVE, OR WHO ARE AT RISK FOR DEVELOPING CHRONIC ILLNESS.FY20: DUE TO COVID-19, COUNSELING WAS SUSPENDED FROM MID-MARCH TO JUNE. ONCE SESSIONS RESUMED, 59 COUNSELING SESSIONS WERE COMPLETED FOR 21 CLIENTS WITH VARIOUS CHRONIC HEALTH CONDITIONS. IN ADDITION, REQUESTS FOR FOOD ASSISTANCE WERE UP 27% AS A RESULT OF THE IMPACTS OF COVID. AS A RESULT, 9,585 PEOPLE WERE PROVIDED WITH FREE FOOD (1,954,401 MEALS/ 2,345,281 POUNDS). FY21: THE RD CONDUCTED 5 SENIOR WORKSHOPS REACHING 51 SENIORS AND 9 FAMILY WORKSHOPS REACHING 89 PARTICIPANTS. FY22: A TOTAL OF 1500 PEOPLE WERE ENROLLED IN THE PROGRAM AND RECEIVED NUTRITION COUNSELING AND/OR EDUCATION VIA AN ONLINE OR IN PERSON SESSION. IN ADDITION, 3,376 POUNDS OF FREE FOOD WAS DISTRIBUTED. CONNECTING YOUNG MOMS - NHC PROVIDED THE CONNECTING YOUNG MOMS (CYM) PROGRAMS OFFERING COMPREHENSIVE PRE- AND POSTNATAL PROGRAMS, INCLUDING CHILDBIRTH PREPARATION, TO YOUNG MOTHERS AND THEIR CHILDREN. FY20:50 WOMEN PARTICIPATED IN THE PROGRAM, WHICH WAS HELD REMOTELY TO COMPLY WITH COVID-19 DISTANCING GUIDELINES. FY21:55 WOMEN PARTICIPATED IN THE PROGRAM. FY22: 77 WOMEN PARTICIPATED IN THE PROGRAM GLOUCESTER SCHOOL BASED HEALTH CENTER - NHC, WITH SUPPORT FROM FUNDING RECEIVED BY THE DEPARTMENT OF PUBLIC HEALTH, FACILITATED A SCHOOL BASED HEALTH CENTER AT THE GLOUCESTER HIGH SCHOOL. THE PROGRAM INCLUDES NURSE PRACTITIONER AND SOCIAL WORKER VISITS ALONG WITH VARIOUS EDUCATIONAL OUTREACH ACTIVITIES SUCH AS SOCIAL SKILLS WORK GROUPS AND REPRODUCTIVE HEALTH CLASSES. IN ADDITION, THE CENTER REDUCED BARRIERS TO FOOD ACCESS (EXASPERATED BY COVID) BY CREATING A FOOD LOCKER FOR STUDENTS IN NEED. FY20: 719 NURSE PRACTITIONER VISITS AND 707 SOCIAL WORKER VISITS WERE CONDUCTED, 2873 ASSESSMENTS WERE COMPLETED, AND 21 OUTREACH ACTIVITIES WERE CONDUCTED. IN ADDITION, THE CENTER REDUCED BARRIERS TO FOOD ACCESS (EXASPERATED BY COVID) BY DELIVERING 449 FOOD ORDERS (VIA CONTACTLESS DELIVERY) TO 56 STUDENTS AND THEIR FAMILIESFY21: CONDUCTED 567 NURSE PRACTITIONER VISITS, 637 VIRTUAL OR IN - PERSON SOCIAL WORKER VISITS, COMPLETED 1958 ASSESSMENTS, AND 21 OUTREACH ACTIVITIES INCLUDING SOCIAL SKILLS WORK GROUPS AND REPRODUCTIVE HEALTH CLASSES. IN ADDITION, THE CENTER DELIVERED 449 FOOD ORDERS (VIA CONTACTLESS DELIVERY) TO 56 STUDENTS AND THEIR FAMILIES. FY22: CONDUCTED 975 NURSE PRACTITIONER VISITS, 830 SOCIAL WORKER VISITS, COMPLETED 1958 ASSESSMENTS, AND 43 OUTREACH ACTIVITIES REACHING 545 STUDENTS. IN ADDITION, THE CENTER'S NEW FOOD LOCKER PROGRAM PROVIDED 520 FOOD ORDERS FOR 55 STUDENTS, ALONG WITH 290 CONTACTLESS DELIVERIES FOR STUDENTS AND FAMILIES IN NEED. SHINE PROGRAM - THE SERVING THE HEALTH INFORMATION NEEDS OF EVERYONE (SHINE) PROGRAM PROVIDED HEALTH INSURANCE COUNSELING SERVICES TO ELDERLY AND DISABLED ADULTS. FY20: 3,226 SESSIONS WERE CONDUCTED FOR RESIDENTS IN NHC'S CBSA.FY21: DUE TO COVID RESTRICTIONS, SHINE COUNSELORS CONDUCTED 3682 VISITS/SESSIONS VIA TELEPHONE IN FY21. FY22: SHINE COUNSELORS CONDUCTED 3,921 SESSIONS FINANCIAL COUNSELORS AT BEVERLY AND ADDISON GILBERT HOSPITAL ASSISTED PATIENTS WITH EXISTING MEDICAID, PATIENTS WHO PRESENTED AS SELF - PAY AND COMPLETED AN APPLICATION WITH A FINANCIAL NAVIGATOR, AND PATIENTS WHO QUALIFIED FOR UPGRADED MASSHEALTH COVERAGE. FY20: 59,500 PATIENTS RECEIVED ASSISTANCEFY21:67,500 PATIENTS RECEIVED ASSISTANCEFY22: 67,500 PATIENTS RECEIVED ASSISTANCE BEVERLY BOOTSTRAPS NHC SUPPORTED BEVERLY BOOTSTRAPS TO PROVIDE HOME DELIVERIES OF GROCERIES TO THE MOST VULNERABLE RESIDENTS.FY20: DUE TO COVID RESTRICTIONS, HOME DELIVERIES ONLY WERE CONDUCTED. MORE THAN 2,350 BAGS OF FOOD WERE HOME DELIVERED TO 520 VULNERABLE COMMUNITY MEMBERS LIVING IN TEN DIFFERENT SENIOR HOUSING SITES.FY21: 26 MOBILE MARKETS WERE HELD, SERVING 183 HOUSEHOLDS, WITH 9,456 POUNDS OF FOOD. DUE TO COVID RESTRICTIONS AT THE BEVERLY SENIOR CENTER, THE MARKETS WERE HELD AT HOUSING FACILITIES IN BEVERLY INCLUDING APPLE VILLAGE, TURTLE CREEK, AND TURTLE WOODS. IN ADDITION, 1,415 HOME DELIVERIES WERE MADE TO THREE DIFFERENT HOUSING SITES IN BEVERLY, SERVING 680 PEOPLE WITH 42,450 POUNDS OF FOOD. FY22: 4,323 LOW-RESOURCED, OLDER ADULTS WERE SERVED THROUGH MOBILE MARKETS AT SENIOR HOUSING SITES. ACTION INC. WELCOME HOME PROGRAM - NHC PROVIDED $25K PER YEAR FROM FY20-FY22 TO ACTION INC. TO SUPPORT THE WELCOME HOME PROGRAM TO HELP CHRONICALLY HOMELESS PEOPLE SECURE AND/OR MAINTAIN PERMANENT HOUSING AND CONNECT THEM WITH MEDICAL SERVICES TO IMPROVE THEIR OVERALL HEALTH. FY20: 79% OF CLIENTS RECEIVED CARE FROM A PCP, 100% OF CLIENTS ATTENDED FOLLOW-UP APPOINTMENTS OR FOLLOWED THROUGH ON REFERRALS FROM A PCP, EMERGENCY DEPARTMENT USAGE DECREASED BY 45% AMONG OUR CLIENTS, AND 100% OF CLIENTS REMAINED IN THEIR HOUSING OR EXITED TO OTHER PERMANENT HOUSING DESTINATIONS.FY21: 11 CHRONICALLY HOMELESS INDIVIDUALS SECURED AND MAINTAINED PERMANENT SUPPORTIVE HOUSING. IN ADDITION, 89% OF FORMERLY HOMELESS CLIENTS ENROLLED IN THE PROGRAM RECEIVED CARE FROM A PCP. FY22: 11 CHRONICALLY HOMELESS INDIVIDUALS SECURED AND MAINTAINED PERMANENT SUPPORTIVE HOUSING. WELLSPRING HOUSE PATHWAYS TO JOBS PROGRAM NHC AWARDED FINANCIAL SUPPORT TO WELLSPRING HOUSE TO PROVIDE INTENSIVE EDUCATION, JOB TRAINING AND CAREER COUNSELING TO ADULTS IN THE NORTH SHORE REGION TO HELP THEM OBTAIN EMPLOYMENT OR TRANSITION TO EMPLOYMENT WITH HIGHER WAGES.FY20: 442 ADULTS RECEIVED CAREER COUNSELING.FY21: 150 YOUNG ADULTS COMPLETED THE JOB TRAINING PROGRAMFY22: 261 PEOPLE COMPLETED THE JOB TRAINING PROGRAM. METRO NORTH YMCA HERRING TECHNOLOGY CENTER - NHC AWARDED A ONE-YEAR GRANT TO THE METRO NORTH YMCA IN FY21 FOR DEVELOPMENT OF A NEW TECHNOLOGY CENTER CALLED THE HERRING COMMUNITY TECHNOLOGY CENTER, A NEW SPACE WITHIN THE YMCA WHICH AIMS TO BRIDGE THE DIGITAL DIVIDE BY MAKING INTERNET SERVICES MORE ACCESSIBLE FOR RESIDENTS IN THE CITY OF LYNN. IN FY21 200 LYNN RESIDENTS PARTICIPATED IN PROGRAMS OFFERED AT THE CENTER. ADDRESSING THE DIGITAL DIVIDE - IN RESPONSE TO THE COVID EPIDEMIC, NORTHEAST HOSPITAL CORPORATION AWARDED A ONE-YEAR GRANT TO CAPE ANN MASS IN MOTION/SENIORS ON THE GO IN FY21 FOR THEIR ""ADDRESSING THE DIGITAL DIVIDE"" INITIATIVE WHICH HELPED 77 LOW-INCOME RESIDENTS' ACCESS FREE EQUIPMENT, INTERNET SERVICE AND/OR EDUCATION TO INCREASE THEIR TECHNOLOGY SKILLS IN ORDER TO ACCESS FREE OR AFFORDABLE FOOD, FITNESS CLASSES AND TELEHEALTH MEDICAL APPOINTMENTS. BEVERLY SUMMER LITERACY PROGRAM - NHC PROVIDED FINANCIAL SUPPORT TO THE CITY OF BEVERLY/BUILDING A BETTER BEVERLY TO PROVIDE THE SUMMER LITERACY PROGRAM, A PARTNERSHIP BETWEEN BEVERLY PUBLIC SCHOOLS AND THE GREATER BEVERLY YMCA. THE SIX-WEEK PROGRAM IS DESIGNED TO HELP CHILDREN ACHIEVE GRADE - LEVEL LITERACY AND PROVIDE A SUMMER CAMP OPPORTUNITY TO HELP THEM GROW HEALTHY AND HAPPY. FY20: DUE TO COVID THE PROGRAM WAS CONDUCTED ONLINE, AND 150 CHILDREN PARTICIPATEDFY21: 180 CHILDREN PARTICIPATED IN THE PROGRAMFY22: MORE THAN 200 CHILDREN PARTICIPATED IN THE PROGRAM FY22 CHNA - COMMUNITY BENEFITS STAFF AT ALL BILH HOSPITALS WORKED TOGETHER TO PLAN, IMPLEMENT, AND EVALUATE COMMUNITY BENEFITS PROGRAMS, PLAN THE FY22 COMMUNITY HEALTH NEEDS ASSESSMENT, UNDERSTAND STATE AND FEDERAL REGULATIONS, BUILD EVALUATION CAPACITY, AND COLLABORATE ON IMPLEMENTING SIMILAR PROGRAMS. STAFF ALSO PARTICIPATED IN 6 DIFFERENT EVALUATION WORKSHOPS ON SMART GOALS, LOGIC MODELS, PROCESS AND OUTCOME EVALUATIONS, AND PROGRAM IMPROVEMENT. IN ADDITION, BILH PARTNERED WITH MGB TO DEVELOP A COMMUNITY BENEFITS DATABASE, PART OF A MULTI - YEAR STRATEGIC EFFORT TO STREAMLINE AND IMPROVE THE ACCURACY OF REGULATORY REPORTING, SIMPLIFY THE COLLECTION OF AND ACCESS TO STANDARDIZED FINANCIAL DATA, AND CREATE A UNIFORM, SYSTEM - WIDE TRACKING AND MONITORING MODEL.COMMUNITY PARTNERSNHC IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS."

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
"THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: ACTION INC. AMERICAN CANCER SOCIETY BACKYARD GROWERS BEVERLY BOOTSTRAPS CAPE ANN MASS IN MOTION CHNA 13/14 CITY OF BEVERLY CITY OF GLOUCESTER DANVERSCARES GLOUCESTER SCHOOL DEPT. METRONORTH YMCA NORTH SHORE YMCA THE OPEN DOOR PATHWAYS SENIORCARE, INC. TOWN OF DANVERS TOWN OF ESSEX TOWN OF IPSWICH TOWN OF MANCHESTER BY-THE-SEA TOWN OF MIDDLETON TOWN OF ROCKPORT WELLSPRING HOUSEAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, NHC IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE IS. IN THE FY 2023 - 2025 IS, WHICH WILL GUIDE THE NHC'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025, EXAMPLES OF IDENTIFIED NEEDS THAT WILL NOT BE MET IN THESE YEARS ARE ""SUPPORTING EDUCATION ACROSS THE LIFESPAN AND ""STRENGTHENING THE BUILT ENVIRONMENT"" (I.E. IMPROVING ROADS, SIDEWALKS, ENHANCING ACCESS TO SAFE RECREATIONAL SPACES). IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2019 CHNA THAT ARE NOT INCLUDED IN THE 2019 IS AND WHICH HAVE GUIDED THE NHC'S COMMUNITY BENEFITS ACTIVITIES THE PERIOD FOR THE FISCAL PERIOD COVERED BY THIS FILING, SUCH AS LACK OF AFFORDABLE HOUSING. NHC WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES, FEASIBILITY OF NHC HAVING AN IMPACT, AND/OR BECAUSE IT WAS FELT THAT THE ISSUE WAS BEING ADDRESSED BY OTHER COMMUNITY PARTNERS. AS NOTED IN DETAIL ABOVE, THE NHC'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW NHC CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 11.78% OF NHC'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITSANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, NHC'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT BEVERLY & ADDISON GILBERT HOSPITALS COMMUNITY BENEFITS REPORT FY21.THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT NHC FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSAS REPORTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, NORTHEAST HOSPITAL CORPORATION NHC OPERATES FOUR HOSPITAL SITES BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL: BAYRIDGE HOSPITAL AND LAHEY OUTPATIENT CENTER, DANVERS. THE DANVERS LOCATION IS A HOSPITAL SATELLITE OUTPATIENT FACILITY THAT OFFERS DIAGNOSTIC AND IMAGING SERVICES, ALONG WITH PRIMARY, SPECIALTY, PREVENTATIVE AND URGENT CARE. BAYRIDGE HOSPITAL IS A PSYCHIATRIC FACILITY. BOTH BEVERLY AND ADDISON GILBERT HOSPITALS PROVIDE 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCENHC'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $3,004,999 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, NHC IS ONE OF TEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $55,879,719 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, NHC ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT ENSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, NHC GENERATED $36,892,341 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY NHC FOR SUCH SERVICES BY $6,546,586 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 13.7% OR 73,211 OF NHC 'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 49.7% OR 265,344 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND NHC PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, NHC GENERATED $124,346,942 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $5,754,153. OF THESE AMOUNTS, REVENUE OF $111,232,041 IS RELATED TO THE PROVISION OF HEMATOLOGY & ONCOLOGY, PSYCHIATRY, NEONATOLOGY, PEDIATRIC MEDICINE, INFECTIOUS DISEASE, PULMONARY DISEASE, PEDIATRIC EMERGENCY MEDICINE, UROLOGY, EMERGENCY SERVICES AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $34,817,098. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH NHC CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, NHC HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 2.29%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, NHC ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $2,845,216 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WAS BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990."

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), NORTHEAST HOSPITAL CORPORATION NHC, NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).REVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS' COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINAL SETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED.EMERGENCY CARE ACCESSAS REPORTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, NORTHEAST HOSPITAL CORPORATION NHC OPERATES FOUR HOSPITAL SITES BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL: BAYRIDGE HOSPITAL AND LAHEY OUTPATIENT CENTER, DANVERS. THE DANVERS LOCATION IS A HOSPITAL SATELLITE OUTPATIENT FACILITY THAT OFFERS DIAGNOSTIC AND IMAGING SERVICES, ALONG WITH PRIMARY, SPECIALTY, PREVENTATIVE AND URGENT CARE. BAYRIDGE HOSPITAL IS A PSYCHIATRIC FACILITY. BOTH BEVERLY AND ADDISON GILBERT HOSPITALS PROVIDE MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THIS CARE IS OFFERED FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE NHC IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM NHC AS WELL AS PROVIDERS WHO FOLLOW NHC'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN NHC AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW NHC'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. NHC DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY THE HOSPITAL'S BOARD EFFECTIVE ON OR ABOUT AUGUST 15, 2020.FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICYTRANSLATIONS (SCHEDULE H PART V SECTION B QUESTION 16I)THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ARABIC ARMENIAN CAMBODIAN CAPE VERDEAN CHINESE FRENCH GREEK HAITIAN CREOLE HINDI ITALIAN JAPANESE KOREAN MON-KHMER PORTUGUESE PUNJABI RUSSIAN SPANISH VIETNAMESEFINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT: FINANCIAL ASSISTANCE POLICY (ENGLISH) - UPDATED 1/2023 (BEVERLYHOSPITAL.ORG)IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE NHC FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, ARABIC, ARMENIAN, CAPE VERDEAN, FRENCH, GREEK, GUJARATI, HAITIAN CREOLE, HINDI, ITALIAN, KHMER, PORTUGUESE, PUNJABI, RUSSIAN, SIMPLIFIED CHINESE, SPANISH, TRADITIONAL CHINESE, AND VIETNAMESE, CAN BE FOUND ON THE NHC WEBSITE AT: HTTPS://WWW.BEVERLYHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTHLIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES, OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED THROUGHOUT THIS FILING NHC IS PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER IN BOSTON AND A SISTER ENTITY OF NHC. AS PART OF THE SAME NETWORK, THE RESEARCH IN WHICH BIDMC ENGAGES SUPPORTS NOT ONLY THE MISSION AND CARE FOR BIDMC PATIENTS AND COMMUNITIES BUT ALSO HELPS TO IMPROVE PATIENT CARE FOR THE COMMUNITIES OF OTHER BILH AFFILIATES AND BEYOND. THE DETAIL BELOW PROVIDES BACKGROUND ON THE RESEARCH ACTIVITIES AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,800 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,400 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD - REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 260 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY.

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH - QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES: ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE EMERGENCY MEDICINE MEDICINE O ALLERGY AND INFLAMMATIONO CARDIOVASCULAR MEDICINEO CENTER FOR VASCULAR BIOLOGY RESEARCHO CENTER FOR VIROLOGY AND VACCINE RESEARCHO CLINICAL INFORMATICSO CLINICAL NUTRITIONO ENDOCRINOLOGYO EXPERIMENTAL MEDICINEO GASTROENTEROLOGYO GENERAL MEDICINE AND PRIMARY CAREO GENETICSO GERONTOLOGYO HEMATOLOGY AND ONCOLOGYO HEMOSTASIS AND THROMBOSISO IMMUNOLOGYO INFECTIOUS DISEASEO INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGYO MOLECULAR AND VASCULAR MEDICINEO NEPHROLOGYO PULMONOLOGYO RHEUMATOLOGYO SIGNAL TRANSDUCTIONO TRANSLATIONAL RESEARCHO TRANSPLANT IMMUNOLOGY NEONATOLOGY NEUROLOGY OBSTETRICS AND GYNECOLOGY ORTHOPAEDIC SURGERY PATHOLOGY PSYCHIATRY RADIOLOGY SURGERY O CARDIAC SURGERYO CENTER FOR MINIMALLY INVASIVE SURGERYO NEUROSURGERYO PLASTIC AND RECONSTRUCTIVE SURGERYO VASCULAR SURGERY TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $241,262,451 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 3.02% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $312,605,756 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX - EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS ON SCHEDULE H, PART I LINE 7H COLUMN D, WHICH, IF INCLUDED IN SCHEDULE H, PART I, LINE 7H COLUMN E CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 1.04%.RESEARCH ENGAGED IN AT THE MEDICAL CENTERTHE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. COVID-19 VACCINE RESEARCHALTHOUGH THE PERIOD COVERED BY THIS FILING IS THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, BIDMC IS FILING THIS RETURN ON OR BEFORE THE EXTENDED DUE DATE WHICH IS AUGUST 17, 2020. IN THE INTERVENING MONTHS SINCE THE END OF THE FISCAL PERIOD COVERED BY THIS FILING, THE COVID-19 PANDEMIC HAS CHANGED LIFE IN THE UNITED STATES AND ACROSS THE GLOBE. WHILE THE COVID-19 PANDEMIC BEGAN AFTER THE END OF FY 2019, RESEARCH CONDUCTED AT BIDMC DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 SET THE STAGE FOR BIDMC'S NATIONAL LEADERSHIP DURING THIS ONGOING PUBLIC HEALTH CRISIS. IT IS FOR THIS REASON, THAT BIDMC IS INCLUDING DETAIL IN THIS FILING RELATED TO COVID-19 RESEARCH EVEN THOUGH THIS RESEARCH COMMENCED AFTER THE END OF THE FISCAL PERIOD COVERED BY THIS FILING. AS OF LATE JULY, 2020, NEARLY FOUR MILLION COVID-19 INFECTIONS HAVE BEEN REPORTED IN THE UNITED STATES. PUBLIC HEALTH LEADERS HAVE SUGGESTED THAT EFFORTS TO ENFORCE PHYSICAL DISTANCING INCLUDING MASK MANDATES AND STAY-AT-HOME ADVISORIES MAY HAVE TO REMAIN IN PLACE, IF INTERMITTENTLY, UNTIL SCIENTISTS DEVELOP A VACCINE FOR COVID-19.BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IMMUNOLOGIST DAN BAROUCH, MD, PHD HAS BECOME A WORLD LEADER IN THE RACE TO DEVELOP A VACCINE AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19. AS DIRECTOR OF BIDMC'S CENTER FOR VIROLOGY AND VACCINE RESEARCH (CVVR), BAROUCH AND HIS COLLEAGUES BEGAN WORKING ON A COVID-19 VACCINE ON JANUARY 10, 2020, THE SAME NIGHT THAT CHINESE SCIENTISTS RELEASED THE SARS-COV-2 VIRUS'S GENOME. BAROUCH'S TEAM QUICKLY DESIGNED A SERIES OF VACCINE CANDIDATES, WHICH ARE CURRENTLY BEING EVALUATED IN CLINICAL STUDIES AND LED BY PRIMARY INVESTIGATOR KATHRYN E. STEPHENSON, MD, MPH, DIRECTOR OF THE CLINICAL TRIALS UNIT AT CVVR.DR. BAROUCH'S INNOVATIVE VACCINE DESIGN USES A COMMON-COLD VIRUS, CALLED THE ADENOVIRUS, TO DELIVER A SMALL BIT OF THE COVID-19 DNA INTO HOST CELLS, WHERE IT STIMULATES THE BODY TO RAISE IMMUNE RESPONSES AGAINST THE VIRUS. IF PROVEN SAFE AND EFFECTIVE, THE COVID-19 VACCINE COULD BE AVAILABLE FOR EMERGENCY USE BY EARLY 2021, WHICH MAY BE THE SHORTEST TIME FROM VIRAL EMERGENCE TO VACCINE IN MEDICAL HISTORY.OVER THE LAST 20 YEARS, DR. BAROUCH HAS APPLIED THE ADENOVIRUS STRATEGY FOR USE AGAINST PATHOGENS SUCH AS HIV AND ZIKA. ONE SUCH CANDIDATE HIV VACCINE DEVELOPED BY DR. BAROUCH AND COLLEAGUES IS CURRENTLY IN CLINICAL EFFICACY TRIALS AT SITES AROUND THE WORLD, THE ONLY REMAINING HIV VACCINE CURRENTLY IN LARGE-SCALE CLINICAL TRIALS. DETAIL ON ADDITIONAL NON-COVID RESEARCH EFFORTS WHICH WERE UNDERTAKEN DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. LARGE INTERNATIONAL STUDY CONFIRMS MEASURING BONE MICROARCHITECTURE WITH NEW IMAGING TECHNOLOGY ACCURATELY PREDICTS RISK OF FRACTURE IN OLDER WOMEN AND MENIN THE LARGEST PROSPECTIVE STUDY OF ITS KIND, RESEARCHERS FROM BETH ISRAEL DEACONESS MEDICAL CENTER AND THE INSTITUTE FOR AGING RESEARCH AT HEBREW SENIORLIFE USED HIGH-RESOLUTION TOMOGRAPHY IMAGING TO ASSESS WHETHER OTHER BONE CHARACTERISTICS BESIDES BONE MINERAL DENSITY CAN BE USED TO DETERMINE FRACTURE RISK.EVERY YEAR MORE THAN TWO MILLION OLDER AMERICANS EXPERIENCE A FRAGILITY FRACTURE TO THE HIP, SPINE OR WRIST. LOSS OF BONE MINERAL DENSITY (BMD) THE CONDITION KNOWN AS OSTEOPOROSIS IS ONE WAY BONES CAN BECOME FRAGILE, AND SCREENING PATIENTS FOR OSTEOPOROSIS IS THE CURRENT STANDARD FOR DETERMINING FRACTURE RISK IN OLDER ADULTS. HOWEVER, LOW BONE MINERAL DENSITY IS NOT THE ONLY CAUSE OF BONE FRAGILITY, AND THE MAJORITY OF OLDER ADULTS WHO SUSTAIN A FRAGILITY FRACTURE DO NOT MEET THE DIAGNOSTIC CRITERIA FOR OSTEOPOROSIS.THE TEAM FOUND THAT ASSESSING THE MICROSTRUCTURE OF THE TWO DIFFERENT TYPES OF BONE TISSUES COMPACT BONE AND SPONGY BONE MAY BE USEFUL TO PREDICT THE INCIDENCE OF FRAGILITY FRACTURES IN THOSE WHO WOULD NOT OTHERWISE BE IDENTIFIED AS AT RISK. STUDY CO-LEAD AUTHOR MARY L. BOUXSEIN, PHD, DIRECTOR OF THE CENTER FOR ADVANCED ORTHOPEDIC STUDIES AT BIDMC, AND COLLEAGUES PUBLISHED THEIR FINDINGS IN THE LANCET DIABETES AND ENDOCRINOLOGY.

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
"SURGE PROTECTOR: NOVEL APPROACH TO SUPPRESSING THERAPY-INDUCED TUMOR GROWTHIN A PREVIOUS STUDY, A TEAM OF RESEARCHERS LED BY DIPAK PANIGRAHY, MD, A PATHOLOGIST AT BETH ISRAEL DEACONESS MEDICAL CENTER, DEMONSTRATED THAT DEAD AND DYING CANCER CELLS KILLED BY CONVENTIONAL CANCER TREATMENTS PARADOXICALLY TRIGGER THE INFLAMMATION THAT PROMOTES TUMOR GROWTH AND METASTASIS. NOW, IN A FOLLOW-UP STUDY PUBLISHED IN PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCE, PANIGRAHY AND COLLEAGUES ILLUMINATE THE MECHANISM BY WHICH DEBRIS GENERATED BY OVARIAN TUMOR CELLS TARGETED BY FIRST-LINE CHEMOTHERAPY ACCELERATES TUMOR PROGRESSION. ADDITIONALLY, THE RESEARCHERS DESCRIBE A NOVEL APPROACH TO SUPPRESSING THE CHEMOTHERAPY-INDUCED TUMOR GROWTH. DR. PANIGRAHY AND COLLEAGUE'S ANALYSIS REVEALED THAT CHEMOTHERAPY-KILLED OVARIAN CANCER CELLS INDUCE SURROUNDING IMMUNE CELLS CALLED MACROPHAGES TO RELEASE A SURGE OF IMMUNE-RELATED CHEMICAL COMPOUNDS CYTOKINES AND LIPID MEDIATORS THAT CREATE OPTIMAL CONDITIONS IN WHICH TUMORS CAN SURVIVE AND GROW. NEXT, THE TEAM SHOWED THAT A COMMON ANTI-INFLAMMATORY DRUG CALLED A DUAL COX-2 INHIBITOR BLOCKED THE SURGE OF TUMOR-FRIENDLY CYTOKINES AND LIPIDS. ""THE ROLE OF THESE CHEMOTHERAPY-INDUCED CYTOKINES AND LIPIDS IS UNDERAPPRECIATED AND POORLY CHARACTERIZED, AND OVARIAN CANCER PATIENTS MAY BENEFIT FROM SUPPRESSING THEIR RELEASE,"" SAID DR. PANIGRAHY. ""FURTHER RESEARCH IS NEEDED BUT, DUAL INHIBITION OF THE COX-2 PATHWAYS IS A NOVEL THERAPEUTIC MODALITY THAT MAY COMPLIMENT CONVENTIONAL CANCER THERAPIES BY ACTING AS A SURGE PROTECTOR AGAINST CELL DEBRIS-STIMULATED TUMOR GROWTH."" PREVENTING POSTOPERATIVE DELIRIUMAS MANY AS HALF OF ALL PATIENTS WHO UNDERGO CARDIAC SURGERY MAY EXPERIENCE DELIRIUM, A FORM OF ACUTE CONFUSION THAT CAN RESULT IN DISORIENTATION, IMPAIRED MEMORY, DELUSIONS, AND ABRUPT CHANGES IN MOOD AND BEHAVIOR, INCLUDING AGGRESSION. IN A STUDY PUBLISHED IN THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, PHYSICIAN-RESEARCHERS LED BY BALACHUNDHAR SUBRAMAINAM, MD, PHD, DIRECTOR OF THE CENTER FOR ANESTHESIA RESEARCH EXCELLENCE IN THE DEPARTMENT OF ANESTHESIA, CRITICAL CARE AND PAIN MEDICINE AT BETH ISRAEL DEACONESS MEDICAL CENTER FOUND THAT INTRAVENOUS ACETAMINOPHEN SIGNIFICANTLY REDUCED THE INCIDENCE OF POSTOPERATIVE DELIRIUM FOLLOWING CORONARY ARTERY BYPASS PROCEDURES IN PATIENTS OVER 60. THE FINDINGS OF THIS SINGLE-CENTER TRIAL MAY REPRESENT THE FIRST STEPS TOWARD A THERAPEUTIC INTERVENTION FOR THE PREVENTION OF POSTOPERATIVE DELIRIUM, A COMMON AND DEVASTATING COMPLICATION IN THE OFTEN HIGHLY VULNERABLE OLDER ADULTS WHO UNDERGO CARDIAC SURGERY.""CURRENTLY, IV ACETAMINOPHEN ADMINISTRATION IS CONSIDERED AN EXPENSIVE INTERVENTION, AND THERE IS SIGNIFICANT VARIATION IN PAIN MANAGEMENT FOLLOWING CARDIAC SURGERY,"" SAID DR. 2SUBRAMAINAM. ""IF OUR FINDINGS ARE REPLICATED IN A LARGER, MULTICENTER STUDY, POSTOPERATIVE INTRAVENOUS ADMINISTRATION OF ACETAMINOPHEN COULD BECOME A STANDARD OF CARE IN ALL CARDIAC SURGICAL PATIENTS AND COULD BE INCORPORATED IN CARDIAC SURGERY RECOVERY PROTOCOLS.""SURGEONS RETURNED TO MINIMALLY INVASIVE PROCEDURES FOR HYSTERECTOMY AFTER ABANDONING POTENTIALLY CANCER-SPREADING TECHNIQUEA STUDY BY SPECIALISTS AT BETH ISRAEL DEACONESS MEDICAL CENTER CHARACTERIZED NATIONAL TRENDS IN HYSTERECTOMY PRACTICE IN THE WAKE OF A 2014 FDA WARNING THAT A TOOL CALLED A POWER MORCELLATOR INTENDED TO ASSIST WITH MINIMALLY INVASIVE LAPAROSCOPIC HYSTERECTOMY COULD SPREAD CANCER IN SOME WOMEN. AFTER ENDING THE USE OF POWER MORCELLATION, SURGEONS INITIALLY RETURNED TO MORE INVASIVE ABDOMINAL HYSTERECTOMIES IN THE YEAR FOLLOWING THE FEDERAL WARNING, BIDMC'S RESEARCHERS REPORTED IN THE JOURNAL OBSTETRICS & GYNECOLOGY. HOWEVER, THE TEAM OBSERVED AN OVERALL INCREASE IN THE PROPORTION OF MINIMALLY INVASIVE HYSTERECTOMIES PERFORMED SINCE 2012. ""PREVIOUS STUDIES REPORTED AN INCREASE IN ABDOMINAL HYSTERECTOMY IN RESPONSE TO THE FDA SAFETY COMMUNICATION, AND OUR RESULTS ARE CONSISTENT WITHIN THE INITIAL SIX-MONTH PERIOD AFTER THE FIRST CONCERNS ABOUT POWER MORCELLATION WERE REPORTED,"" SAID LEAD AUTHOR ELISA M. JORGENSEN, MD, A MINIMALLY INVASIVE GYNECOLOGY SURGERY FELLOW AT BIDMC. ""HOWEVER, BY LOOKING AT DATA THROUGH 2016, WE FOUND A COMPLETE REVERSAL OF THE PREVIOUSLY REPORTED EFFECT. IN FACT, MINIMALLY INVASIVE HYSTERECTOMY WAS AT ITS PEAK INCIDENCE AT THE END OF OUR FIVE-YEAR STUDY PERIOD."" QUASHING THE RESISTANCE: MICRORNA REGULATES DRUG TOLERANCE IN SUBSET OF LUNG CANCERSRELAPSE OF DISEASE FOLLOWING CONVENTIONAL TREATMENTS REMAINS ONE OF THE CENTRAL PROBLEMS IN CANCER MANAGEMENT, YET FEW THERAPEUTIC AGENTS TARGETING DRUG RESISTANCE AND TOLERANCE EXIST. NEW RESEARCH CONDUCTED AT THE CANCER CENTER AT BETH ISRAEL DEACONESS MEDICAL CENTER FOUND THAT A MICRORNA A SMALL FRAGMENT OF NON-CODING GENETIC MATERIAL THAT REGULATES GENE EXPRESSION MEDIATES DRUG TOLERANCE IN LUNG CANCERS WITH A SPECIFIC MUTATION. THE FINDINGS, PUBLISHED IN NATURE METABOLISM, SUGGEST THAT THE MICRORNA COULD SERVE AS A POTENTIAL TARGET FOR REVERSING AND PREVENTING DRUG TOLERANCE IN A SUBSET OF NON-SMALL-CELL LUNG CANCERS. ""IN THIS STUDY, WE DISCOVERED THAT A MICRORNA KNOWN AS MIR-147B IS A CRITICAL MEDIATOR OF RESISTANCE AMONG A SUBPOPULATION OF TUMOR CELLS THAT ADOPT A TOLERANCE STRATEGY TO DEFEND AGAINST EGFR-BASED ANTICANCER TREATMENTS,"" SAID SENIOR AUTHOR FRANK J. SLACK, PHD, DIRECTOR OF THE HMS INITIATIVE FOR RNA MEDICINE AT THE CANCER CENTER AT BIDMC. ""WE ARE CURRENTLY TESTING THE IDEA OF TARGETING THIS NEW PATHWAY AS A THERAPY IN CLINICALLY RELEVANT MOUSE MODELS OF EGFR-MUTANT LUNG CANCER.""READING CLINICIAN VISIT NOTES CAN IMPROVE PATIENTS' ADHERENCE TO MEDICATIONSA STUDY OF PATIENTS READING THE VISIT NOTES THEIR CLINICIANS WRITE, REPORT POSITIVE EFFECTS ON THEIR USE OF PRESCRIPTION MEDICATIONS. PUBLISHED IN THE ANNALS OF INTERNAL MEDICINE, THE STUDY SHOWS THAT WHEN PATIENTS READ THEIR NOTES, THEY REPORT SIGNIFICANT BENEFITS, INCLUDING FEELING MORE COMFORTABLE WITH AND IN CONTROL OF THEIR MEDICATIONS, A GREATER UNDERSTANDING OF MEDICATION'S SIDE EFFECTS, AND BEING MORE LIKELY TO TAKE MEDICATIONS AS PRESCRIBED. THE STUDY OF APPROXIMATELY 20,000 ADULT PATIENTS AT BETH ISRAEL DEACONESS MEDICAL CENTER IN BOSTON AND TWO OTHER HEALTH SYSTEMS WAS CONDUCTED ONLINE BETWEEN JUNE AND OCTOBER OF 2017. THE THREE HEALTH SYSTEMS HAVE BEEN SHARING VISIT NOTES WRITTEN BY PRIMARY CARE DOCTORS, MEDICAL AND SURGICAL SPECIALISTS, AND OTHER CLINICIANS FOR SEVERAL YEARS. ""SHARING CLINICAL NOTES WITH PATIENTS IS A RELATIVELY LOW-COST, LOW-TOUCH INTERVENTION,"" SAID STUDY LEAD CATHERINE DESROCHES, DRPH, EXECUTIVE DIRECTOR OF OPENNOTES, OF THE DIVISION OF GENERAL MEDICINE AT BIDMC AND AN ASSOCIATE PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. ""WHILE NOTE SHARING REQUIRES A CULTURE SHIFT IN MEDICINE, IT IS NOT TECHNICALLY DIFFICULT WITH MOST ELECTRONIC HEALTH RECORD SYSTEMS (EHRS), AND COULD HAVE AN ENORMOUS PAYOFF, GIVEN THAT WE KNOW POOR ADHERENCE TO MEDICATIONS COSTS THE HEALTH CARE SYSTEM ABOUT $300 BILLION PER YEAR. ANYTHING THAT WE CAN DO TO IMPROVE ADHERENCE TO MEDICATIONS HAS SIGNIFICANT VALUE.""STUDY: LEVELS OF LIVER FAT BIOMARKER ASSOCIATED WITH METABOLIC HEALTH BENEFITS OF REGULAR EXERCISEWHILE GENETICS AND OTHER FACTORS LIKE AGE AND GENDER CONTRIBUTE TO EACH INDIVIDUAL'S RESPONSE TO EXERCISE, LITTLE IS KNOWN ABOUT THE BIOLOGICAL MECHANISMS BY WHICH PHYSICAL ACTIVITY BRINGS ABOUT BENEFICIAL CHANGES TO THE BODY. IN A STUDY LED BY CARDIOLOGISTS AT BETH ISRAEL DEACONESS MEDICAL CENTER, SCIENTISTS FOUND THAT INCREASING EXERCISE CAN LOWER LEVELS OF DIMETHYLGUANIDINO VALERIC ACID (DMVG), A MOLECULE IN THE BLOOD LINKED TO POOR HEALTH OUTCOMES. HOWEVER, THE RESEARCHERS WERE SURPRISED TO FIND THAT PEOPLE WITH HIGHER BASELINE LEVELS OF DMVG THOSE WITH ""MORE ROOM TO IMPROVE"" ACTUALLY SAW LESS BENEFIT FROM EXERCISE THAN PEOPLE WITH LOWER BASELINE LEVELS OF DMVG THOSE IN BETTER HEALTH TO BEGIN WITH.LED BY CORRESPONDING AUTHOR ROBERT GERSZTEN, MD, CHIEF OF CARDIOVASCULAR MEDICINE AT BIDMC, THE SCIENTISTS WERE INTERESTED IN STUDYING DMGV BASED ON THEIR PREVIOUS RESEARCH FINDINGS SHOWING THAT THE MOLECULE WAS A MARKER OF LIVER FAT AND THAT CIRCULATING LEVELS WERE TIED THE DEVELOPMENT OF TYPE 2 DIABETES UP TO 12 YEARS PRIOR TO DISEASE ONSET. THE STUDY WAS PUBLISHED IN JAMA CARDIOLOGY.STRUCTURE OF ENZYME THAT PRODUCES FUEL FOR THE HEART OF MUSCLE CELLS REVEALED AFTER SIXTY YEARS OF INTENSIVE INVESTIGATION BY BIOCHEMISTS AND PHYSIOLOGISTS WORLDWIDE, A TEAM OF SCIENTISTS LED BY GABRIEL BIRRANE, PHD, A STRUCTURAL BIOLOGIST AT BETH ISRAEL DEACONESS MEDICAL CENTER, PROVIDED THE FIRST DETAILED PICTURE OF THE STRUCTURE OF THE LIPOPROTEIN LIPASE (LPL) PROTEIN. THE TEAM'S FINDINGS, PUBLISHED IN THE PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, OFFER A BETTER UNDERSTANDING OF CARDIOVASCULAR METABOLISM AND COULD OPEN THE DOOR TO TARGETED TREATMENT FOR SEVERAL RARE CARDIOVASCULAR DISORDERS."

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
"""BECAUSE LPL ALONE IS NOT VERY STABLE, PREVIOUS EXPERIMENTERS HAD DIFFICULTY PRODUCING SUFFICIENT AMOUNTS LPL FOR STRUCTURAL ANALYSIS,"" EXPLAINED DR. BIRRANE. ""MY COLLABORATORS PROVIDED THE BREAKTHROUGH DATA, INCLUDING METHODS TO PURIFY ACTIVE LPL AND A COMPANION PROTEIN THAT WAS CRUCIAL TO STABILIZE LPL. WITH THIS KNOWLEDGE, WE CONCENTRATED OUR EFFORTS ON CRYSTALLIZING A COMPLEX OF THE TWO PROTEINS. CRYSTALS OF THE COMPLEX PRODUCED X-RAY DATA OF MUCH HIGHER QUALITY THAN WE WERE ABLE TO OBTAIN WITH LPL ALONE AND THIS ALLOWED US TO ANALYZE THE STRUCTURE AT A MOLECULAR LEVEL."" NOW THAT THE TEAM HAS REVEALED THE STRUCTURE OF THE PROTEIN COMPLEX, RESEARCHERS CAN UNDERSTAND HOW MUTATIONS IN LPL OR GPIHBP1 LEAD TO ELEVATED TRIGLYCERIDE LEVELS AND CORONARY ARTERY DISEASE. OTHER MOLECULES BIND TO AND REGULATE THE FUNCTION OF LPL. IN FOLLOW UP STUDIES, DR. BIRRANE AND HIS COLLABORATORS WOULD LIKE TO DETERMINE THESE MOLECULES' MECHANISM OF ACTION, INFORMATION THAT WILL ALLOW SCIENTISTS TO BETTER UNDERSTAND THE ROLE LPL PLAYS IN CARDIOVASCULAR DISEASE AND DIABETES. BOTSWANA STUDY OF HIV MEDICATION SAFETY IN PREGNANCY HAS LESSONS FOR THE USBABIES BORN TO WOMEN TAKING THE HIV THERAPY DOLUTEGRAVIR ARE AT A SLIGHTLY INCREASED RISK OF BIRTH DEFECTS CALLED NEURAL TUBE DEFECTS WHICH AFFECT THE BRAIN, SPINE, AND SPINAL CORD, ACCORDING TO A STUDY PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE. THE FINDINGS, PRESENTED BY INFECTIOUS DISEASE SPECIALIST REBECCA ZASH, MD, AN ASSISTANT PROFESSOR OF MEDICINE AT BETH ISRAEL DEACONESS MEDICAL CENTER AND A RESEARCH FELLOW AT THE HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH, AT THE 10TH INTERNATIONAL AIDS SOCIETY CONFERENCE IN MEXICO CITY, COULD IMPACT TREATMENT GUIDELINES AROUND ANTIRETROVIRAL CHOICES FOR WOMEN OF REPRODUCTIVE AGE. ""WHEN DOLUTEGRAVIR CAME OUT, IT WAS POISED TO BECOME THE MOST WIDELY RECOMMENDED ANTIRETROVIRAL MEDICATION BECAUSE IT IS VERY EFFECTIVE AGAINST HIV AND IS PARTICULARLY WELL TOLERATED,"" SAID DR. ZASH. ""OUR STUDY SHOWS THAT DOLUTEGRAVIR IS NOT NECESSARILY A MAGIC BULLET AND CONTINUED EFFORTS ARE NEEDED TO DEVELOP NOVEL HIV TREATMENTS. WE PLAN TO CONTINUE OUR WORK IN BOTSWANA TO STUDY THE SAFETY OF CURRENT AND NEW ANTIRETROVIRAL MEDICATIONS IN PREGNANCY.""RESEARCHERS FIND WIDESPREAD ASPIRIN USE DESPITE FEW BENEFITS, HIGH RISKSASPIRIN USE IS WIDESPREAD AMONG GROUPS AT RISK FOR HARM INCLUDING OLDER ADULTS AND ADULTS WITH PEPTIC ULCERS PAINFUL SORES IN THE LINING OF THE STOMACH THAT ARE PRONE TO BLEEDING THAT AFFECT ABOUT ONE IN TEN PEOPLE. IN A RESEARCH REPORT PUBLISHED IN ANNALS OF INTERNAL MEDICINE, RESEARCHERS FROM BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) REPORT ON THE EXTENT TO WHICH AMERICANS 40 YEARS OLD AND ABOVE USE ASPIRIN FOR PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE. ""ALTHOUGH PRIOR AMERICAN HEART ASSOCIATION AND AMERICAN COLLEGE OF CARDIOLOGY GUIDELINES RECOMMENDED ASPIRIN ONLY IN PERSONS WITHOUT ELEVATED BLEEDING RISK, THE 2019 GUIDELINES NOW EXPLICITLY RECOMMEND AGAINST ASPIRIN USE AMONG THOSE OVER THE AGE OF 70 WHO DO NOT HAVE EXISTING HEART DISEASE OR STROKE,"" SAID SENIOR AUTHOR CHRISTINA C. WEE, MD, MPH, A GENERAL INTERNIST AND RESEARCHER AT BIDMC AND ASSOCIATE PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. ""OUR FINDINGS SUGGEST THAT A SUBSTANTIAL PORTION OF ADULTS MAY BE TAKING ASPIRIN WITHOUT THEIR PHYSICIAN'S ADVICE AND POTENTIALLY WITHOUT THEIR KNOWLEDGE."" FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION DURING THE FISCAL YEAR COVERED BY THIS FILING, NHC HAD NET EXPENDITURES OF $324,013 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO NHCS TEACHING FUNCTION WHICH REPRESENTED NHC .05% OF THE NHC'S TOTAL EXPENSES.NHC - ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)OPEN MEDICAL STAFF AND COMMUNITY BOARDTHE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS.AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, NHC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON - PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH - QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.BETH ISRAEL LAHEY HEALTH (BILH) IS THE PARENT AND A SUPPORT ORGANIZATION OF THE BILH NETWORK OF AFFILIATES. THE NETWORK COMPRISES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM INCLUDES ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BILH SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - - MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL - - NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - - PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. AS A SUPPORT ORGANIZATION OF THESE ENTITIES, BILH PROVIDES CENTRALIZED SERVICES AND SUPPORT TO ITS AFFILIATES IN AREAS SUCH AS MANAGEMENT, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFITS, DEVELOPMENT AND FUNDRAISING, LEGAL SERVICES, FINANCE, TREASURY, INVESTMENT, INSURANCE, COMPLIANCE AND TAXATION AS WELL AS PATIENT CARE CONTRACTING AND OTHER SERVICES.BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH - QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.BILH IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD - CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;"

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
"BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30, 2022SINCE COMING TOGETHER AS A HEALTH SYSTEM, BETH ISRAEL LAHEY HEALTH (""BILH"") HAS CONTINUED TO MAKE SIGNIFICANT INVESTMENTS AND UNDERTAKE INITIATIVES TO IMPROVE ACCESS FOR PATIENTS AND SUPPORT ITS SURROUNDING COMMUNITIES. IN FY 2022 ALONE, BILH INVESTED OVER $8 MILLION IN ITS COMMUNITY HEALTH CENTER PARTNERS AND SAFETY NET AFFILIATES, DEVELOPED ACCESSIBLE PATIENT MESSAGING AND EDUCATION, AND INVESTED OVER $5 MILLION IN SEVERAL BEHAVIORAL HEALTH-FOCUSED INITIATIVES. BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (""BILHPN"") CONTINUES TO OPTIMIZE ITS POPULATION HEALTH-FOCUSED INITIATIVES, INCLUDING THOSE FOCUSED ON ADDRESSING HEALTH DISPARITIES. HIGHLIGHTS OF THE SYSTEM'S EFFORTS INCLUDE: ENHANCED ACCESS FOR MASSHEALTH PATIENTS TO MITIGATE BARRIERS IN ACCESS TO CARE AND INCREASE THE NUMBER OF MASSHEALTH PATIENTS THAT BILH SERVES, THE SYSTEM COMMITTED TO UNIVERSAL NETWORK-WIDE PROVIDER PARTICIPATION IN MASSHEALTH. SPECIFICALLY, AS OF OCTOBER 2020, ALL BILH HOSPITALS AND PROVIDERS EMPLOYED BY BILH OR ON WHOSE BEHALF BILH JOINTLY CONTRACTS HAVE APPLIED TO PARTICIPATE IN SOME FORM OF MASSHEALTH. IN FY 2022, BILH SIGNED A NEW MASSHEALTH ACO CONTRACT WITH BMC HEALTHNET PLAN / WELLSENSE HEALTH PLAN THAT WILL GO INTO EFFECT IN APRIL 2023. AS PART OF THIS CONTRACT, BILHPN WILL EXTEND PARTICIPATION TO ALL ELIGIBLE PRIMARY CARE PROVIDERS (""PCPS"") WHO WERE NOT OTHERWISE PARTICIPATING IN A MASSHEALTH ACO. WHILE ALL ELIGIBLE BILHPN PCPS WERE PARTICIPANTS IN A FORM OF MASSHEALTH, SOME PCPS HAVE PREVIOUSLY NOT PARTICIPATED IN A MASSHEALTH ACO. DURING FY 2022, BILH DEVELOPED AND REFINED A MULTICULTURAL MARKETING, ADVERTISING, AND OUTREACH PLAN WITH THE PURPOSE OF EXPANDING ACCESS FOR UNDERSERVED POPULATIONS, INCLUDING MASSHEALTH PATIENTS, IN TARGETED BILH SERVICE AREAS. IMPLEMENTATION OF THAT PLAN WILL OCCUR IN FY 2023. INVESTMENTS IN UNDERSERVED COMMUNITIES BILH HOSPITALS HAVE CREATED STRONG CONNECTIONS TO A NETWORK OF AFFILIATED HOSPITALS AND HEALTH CENTERS THAT PROVIDE COMMUNITY-BASED CARE TO HISTORICALLY UNDERSERVED POPULATIONS. IN THE REGIONS THAT THEY SERVE, THE SAFETY NET AFFILIATES (""SNAS"") AND COMMUNITY CARE ALLIANCE (""CCA"") COMMUNITY HEALTH CENTERS (""CHCS"") ARE THE CORNERSTONE OF BILH'S DELIVERY SYSTEM REGARDING COMMUNITY-BASED CARE FOR MASSHEALTH AND HISTORICALLY UNDERSERVED PATIENTS.O CCA CHCS INCLUDE BOWDOIN STREET HEALTH CENTER, CHARLES RIVER COMMUNITY HEALTH, THE DIMOCK CENTER, FENWAY HEALTH, AND SOUTH COVE COMMUNITY HEALTH CENTER. O SNAS INCLUDE CAMBRIDGE HEALTH ALLIANCE AND SIGNATURE HEALTHCARE BROCKTON HOSPITAL. BILH CONTINUES TO INVEST IN THE CCA CHCS AND SNAS, ENABLING THEM TO EXPAND THEIR CAPABILITIES AND CARE FOR MORE HISTORICALLY UNDERSERVED PATIENTS. IN FY 2022, BILH INVESTED OVER $8 MILLION IN ITS CHCS AND SNAS, IN ADDITION TO ENGAGING IN REGIONAL PLANNING AND COLLABORATIVE PROGRAM DEVELOPMENT. THESE INVESTMENTS REPRESENT ONLY A PORTION OF A MUCH LARGER COMMUNITY BENEFITS INVESTMENT PORTFOLIO THAT IS DESCRIBED IN GREATER DETAIL IN THIS AND OTHER BILH NETWORK TAX FILINGS. BILH IS EXPLORING OPPORTUNITIES WITH CHCS IN ESSEX AND MIDDLESEX COUNTIES. FOR EXAMPLE, BILH HAS ESTABLISHED A TELEHEALTH PILOT PROGRAM BETWEEN PHYSICIANS AT ADDISON GILBERT AND BEVERLY HOSPITALS AND PATIENTS AT NORTH SHORE COMMUNITY HEALTH CENTER. COMMITMENT TO BEHAVIORAL HEALTH CARE BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES IS THE LARGEST MENTAL HEALTH AND SUBSTANCE USE DISORDER NETWORK IN EASTERN MASSACHUSETTS. WITH A FOCUS ON COMMUNITY HEALTH, BILH BEHAVIORAL SERVICES SUPPORTS THE NEEDS OF CHILDREN, TEENS, AND ADULTS THROUGH A RANGE OF OPTIONS, FROM INPATIENT CARE TO COMMUNITY-BASED PROGRAMS. IN FY 2022, BILH INVESTED OVER $5 MILLION IN THE FOLLOWING BEHAVIORAL HEALTH INITIATIVES: THE COLLABORATIVE CARE MODEL, CENTRALIZED BED MANAGEMENT PROGRAM, AND MEDICATION ASSISTED THERAPY (""MAT"") AS OF SEPTEMBER 30, 2022, 60 OF 78 EMPLOYED PRIMARY CARE PRACTICES2 ARE PARTICIPATING IN THE IMPACT MODEL, WITH 12 NEW SITES ADDED FROM THE PREVIOUS YEAR. THE IMPACT MODEL (ALSO REFERRED TO AS THE ""COLLABORATIVE CARE"" MODEL) IS A BEHAVIORAL HEALTH INTEGRATION MODEL, WHICH INVOLVES INTRODUCING PRIMARY CARE PATIENTS WHO ARE IDENTIFIED THROUGH SCREENINGS AND DIRECT REFERRALS TO AN EMBEDDED BEHAVIORAL HEALTH CLINICIAN. BILH HAS CONTINUED TO EXPAND ITS BRIDGE CLINICS AT ADDISON GILBERT AND BEVERLY HOSPITALS, INCREASING SAME-DAY ADMISSION FOR MAT PATIENTS FROM 24 TO 40 HOURS PER WEEK, OBTAINING ADDITIONAL STAFF, AND EXPANDING ITS INDUCTION PROGRAM. BILH HAS EXPANDED ITS SYSTEM-WIDE SUBSTANCE USE DISORDER TASKFORCE, DEFINING NEW PATHWAYS FOR CONNECTING BILH PRIMARY CARE TEAMS WITH COMMUNITY ACUTE DETOX AND OTHER ADDICTION-BASED SERVICES, INCREASING THE CAPACITY OF BILH PCPS TO PRESCRIBE MEDICATIONS IN SUPPORT OF OFFICE-BASED ADDICTION TREATMENT, AND PROVIDING EDUCATIONAL TRAININGS TO PCPS TO SCREEN AND TREAT SUBSTANCE USE DISORDERS. THE PRACTICE OF MAT INDUCTION AND REFERRAL IN THE ED AT BID-PLYMOUTH CONTINUED IN FY 2022, WITH RECOVERY NAVIGATORS, AN ADDICTION LPN NURSE, AND A PSYCHIATRIC NP AS AVAILABLE RESOURCES TO PATIENTS. BID-PLYMOUTH ALSO CONTINUED ITS PARTNERSHIP WITH AREA COALITIONS TO HAND OUT SUPPLIES AND RESOURCES, INCLUDING NARCAN, TO THOSE PATIENTS WHO ARE RESIDENTS OF THE AREA AND WHO PRESENT TO THE BID-PLYMOUTH EMERGENCY ROOM WITH AN OPIOID OVERDOSE. ADDITIONAL INFORMATION ON BEHAVIORAL HEALTH IS BELOW.POPULATION HEALTH INITIATIVES BILHPN SUPPORTS AND IMPROVES ACCESS, QUALITY AND EFFICIENCY OF PATIENT-CENTERED CARE BY LEVERAGING BEST PRACTICES IN CLINICAL EXCELLENCE AND DATA ANALYTICS TO HELP PROVIDERS IMPROVE PATIENT HEALTH OUTCOMES. FOR EXAMPLE, BILHPN'S CARE MANAGEMENT TEAM WORKS WITH THE HIGHEST-RISK PATIENTS IN AN EFFORT TO EDUCATE THEM ON THEIR DISEASE, IMPROVE MEDICATION COMPLIANCE, AND HELP THEM NAVIGATE THE COMPLEXITIES OF THE HEALTHCARE SYSTEM. THE GOAL OF BILHPN'S CARE MANAGERS IS TO IMPROVE OUTCOMES FOR PATIENTS WHILE AVOIDING UNNECESSARY EMERGENCY ROOM VISITS OR HOSPITAL STAYS. DURING FY 2022, BILH UNDERTOOK SEVERAL INITIATIVES TO IMPROVE POPULATION HEALTH AND PATIENT CARE, INCLUDING: O BILHPN'S QUALITY TEAM DEVELOPED AND IMPLEMENTED EIGHT TEXT-BASED OUTREACH CAMPAIGNS FOR PATIENTS, ADDRESSING CANCER SCREENINGS, IMMUNIZATIONS, AND DIABETES CARE TO IMPROVE POPULATION HEALTH METRICS.O BILHPN CONTINUED TO OPTIMIZE ITS ENTERPRISE-WIDE POPULATION HEALTH DATA WAREHOUSE TO IDENTIFY PATIENTS WITH CARE GAPS. THROUGH COLLABORATION WITH BILH PHYSICIAN LEADERS, BILHPN MODIFIED PRACTICE WORKFLOWS AND CREATED OUTREACH PROGRAMS TO CLOSE IDENTIFIED GAPS. THESE EFFORTS RESULTED IN BILH REACHING MORE PATIENTS.O DURING FY 2022, BILHPN AND THE BILH OFFICE FOR DIVERSITY, EQUITY AND INCLUSION CO-LED EFFORTS TO INCREASE ACCESS AND IMPROVE OUTCOMES FOR UNDERSERVED POPULATIONS, WITH A FOCUS ON CLOSING DISPARITIES IN DIABETES CARE FOR BLACK AND HISPANIC PATIENTS. ONE AREA OF COLLABORATION CENTERED AROUND A $1.8 MILLION GRANT FROM THE INSTITUTE OF HEALTHCARE IMPROVEMENT / BLUE CROSS BLUE SHIELD OF MASSACHUSETTS THAT ALLOWED THE SYSTEM TO HIRE AND EMBED PATIENT NAVIGATORS WITHIN ITS MOST DIVERSE PRACTICES TO ASSIST PATIENTS ALONG THE CONTINUUM OF CARE. BILH BEHAVIORAL HEALTH SERVICESTHE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. BILHBS (WHICH INCLUDES THE ACTIVITIES OF BILH'S TAX-EXEMPT AFFILIATE NORTHEAST BEHAVIORAL HEALTH CORP) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS. BILHBS' NETWORK OF BEHAVIORAL HEALTH CARE INCLUDES SERVICES FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TREATMENT TO COMMUNITY-BASED PROGRAMS. SERVICES INCLUDE: INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; EMERGENCY PSYCHIATRIC AND MOBILE EMERGENCY SERVICES TEAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION TREATMENT; INDIVIDUAL/COUPLE/FAMILY THERAPY; MEDICATION ASSISTED TREATMENT PROGRAMS; AND SCHOOL-BASED AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES.AS NOTED PREVIOUSLY, SINCE ITS CREATION IN MARCH 2019, BILH HAS CONTINUED TO INVEST SIGNIFICANTLY IN IMPROVING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH A SYSTEM-WIDE APPROACH TO CARE DELIVERY. AS ONE OF SEVERAL ONGOING INITIATIVES, BILH HAS MADE A MULTI-YEAR COMMITMENT TO PROVIDE BEHAVIORAL HEALTH SUPPORT TO ITS EMPLOYED PRIMARY CARE PRACTICES USING AN EVIDENCE-BASED APPROACH KNOWN AS THE IMPACT MODEL. BY THE END OF FY 2022, BILH HAD IMPLEMENTED THE IMPACT MODEL IN 74.36% OF ITS EMPLOYED PRIMARY CARE PRACTICES AS PART OF ITS COLLABORATIVE CARE PROGRAM IMPLEMENTATION."

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
"IN MARCH 2021, BILHBS LAUNCHED ITS CENTRALIZED BED FINDING TEAM. THIS TEAM IS PART OF A BILHBS CENTRAL CALL CENTER, WHICH CENTRALIZES CALLS TO BILHBS' THREE EMERGENCY SERVICE PROGRAM (ESP) CATCHMENT AREAS REDUCING REDUNDANCIES ACROSS THE AGENCY AND STREAMLINING ALL CALLS TO ONE CENTRAL SERVICE. THIS CENTRALIZED BED FINDING TEAM IS RESPONSIBLE FOR CONDUCTING BED SEARCHES FOR PATIENTS SEEN THROUGH THE ESP AND WHO ARE AWAITING AN INPATIENT PSYCHIATRIC PLACEMENT. THIS TEAM DIRECTLY INCREASES THE AVAILABILITY OF CLINICIANS TO CONTINUE TO SEE PATIENTS IN THE EMERGENCY DEPARTMENT (ED) AND THE COMMUNITY WHO ARE EXPERIENCING A BEHAVIORAL HEALTH AND/OR CO-OCCURRING SUBSTANCE USE DISORDER CRISIS WHILE OTHER TEAM MEMBERS SEARCH FOR AVAILABLE INPATIENT PLACEMENTS. THIS INITIATIVE SUPPORTS DECREASED RESPONSE TIME TO RESPONDING TO NEW PATIENTS IN CRISIS AND REDUCES ED BOARDING TIME FOR PATIENTS WHO CAN BE SAFELY MANAGED IN THE COMMUNITY.IN FY2022, THE STATE OF MASSACHUSETTS SET FORTH THE MASSACHUSETTS BEHAVIORAL HEALTH ROADMAP TO INCLUDE FOUR PRIMARY OUTCOMES IN EFFORTS TO ADVANCE HEALTH EQUITY: (1) THE DEVELOPMENT OF COMMUNITY BEHAVIORAL HEALTH CENTERS (CBHCS); (2) SHIFTING BEHAVIORAL HEALTH EMERGENCY SERVICES TO THE COMMUNITY FROM THE EMERGENCY DEPARTMENTS; (3) TREATMENT ON DEMAND (OUTPATIENT EVALUATION AND TREATMENT); AND (4) BEHAVIORAL HEALTH HELP LINE. IN RESPONSE TO THIS MOVEMENT, BILHBS RECEIVED AN AWARD TO OPERATE A CBHC IN THE LAWRENCE LOCATION AND BEGAN THE PLANNING TO PIVOT EMERGENCY SERVICES TEAMS TO SERVE THE BILH SYSTEM EMERGENCY DEPARTMENTS. BILHBS SERVES APPROXIMATELY 35,000 UNDUPLICATED INDIVIDUALS ANNUALLY, OFFERING A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS. SERVICES RANGE FROM INPATIENT TO HOME AND COMMUNITY-BASED SERVICES. BILHBS OPERATES OVER 250 BEDS IN 9 FACILITIES FOR CLIENTS REQUIRING ACUTE PSYCHIATRIC CARE, DETOXIFICATION AND RESIDENTIAL STEP-DOWN SERVICES. DURING THE PERIOD COVERED BY THIS FILING, COMMUNITY-BASED SERVICES INCLUDED MOBILE EMERGENCY SERVICES TEAMS IN THREE CATCHMENT AREAS AND HOME-BASED COUNSELING FOR ADULTS, YOUTH AND THEIR FAMILIES. BILHBS ALSO PROVIDED SERVICES IN 63 MIDDLE AND HIGH SCHOOLS, AS WELL AS 9 POLICE DEPARTMENTS. IN ADDITION, BILH'S COMMUNITY CRISIS STABILIZATION (""CCS"") UNITS IN LAWRENCE AND SALEM, WHICH TYPICALLY CARE FOR PATIENTS WITH MENTAL HEALTH ISSUES, INCREASED THEIR ABILITY TO TREAT PERSONS WITH CO-OCCURRING SUBSTANCE USE DISORDERS. THE CCS UNITS CONTINUE TO BE ABLE TO INDUCT PATIENTS WITH OPIOID USE DISORDER (OUD) ON BUPRENORPHINE AND ARE ALSO ABLE TO MAINTAIN PATIENTS WHO ARE ALREADY ON ANY OF THE THREE FDA APPROVED MEDICATIONS FOR THE TREATMENT OF OUD. THESE UNITS ARE SEEING AN INCREASE IN THE NUMBER OF PATIENTS WITH METHAMPHETAMINE DISORDERS AND HAVE DEVELOPED A PROTOCOL TO MANAGE WITHDRAWAL SYMPTOMS IN THIS POPULATION."

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF NHC'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT NHC ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW NHC, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2022 COMMUNITY HEALTH NEEDS ASSESSMENTPRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, NHC COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF NHC'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES BEVERLY, DANVERS, ESSEX, GLOUCESTER, IPSWICH, LYNN, MANCHESTER BY-THE-SEA, MIDDLETON, AND ROCKPORT. COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR NHC'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).NHC'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF BEVERLY, DANVERS, ESSEX, GLOUCESTER, IPSWICH, LYNN, MANCHESTER BY-THE-SEA, MIDDLETON, AND ROCKPORT AS FOLLOWS: LOW-RESOURCED INDIVIDUALS AND FAMILIES OLDER ADULTS RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS YOUTH2022 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSNORTHEAST HOSPITAL CORPORATION'S 2022 CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING NHC'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. NHC'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, NHC CONDUCTED 18 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED 3 FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 1,341 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS WITH 57 COMMUNITY MEMBERS IN ATTENDANCE (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 1500 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - DETAIL OF APPROACH AND METHODS:NORTHEAST HOSPITAL CORPORATION RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. NHC COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT NHC LEVERAGED INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, 2019 MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) FBI UNIFORM CRIME REPORTS (2019) MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, NHC CONDUCTED 18 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS, AND OTHER KEY COLLABORATORS THROUGHOUT NHC'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON NHC'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN NHC'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)NHC CONDUCTED 3 COMMUNITY FOCUS GROUPS AND HELD 2 COMMUNITY LISTENING SESSIONS THAT ENGAGED 57 RESIDENTS IN NHC'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE NHC'S COMMUNITY PARTNERS SUCH AS ACTION INC., SENIORCARE, THE OPEN DOOR, WELLSPRING HOUSE, AND LOCAL SENIOR CENTERS IN NHC'S CBSA. NHC HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF NHC'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, AND COMMUNITY EVENTS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE NHC COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES.

FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
"3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A NEW MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES;4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES.BILH BEHAVIORAL HEALTH SERVICESTHE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. BILHBS (WHICH INCLUDES THE ACTIVITIES OF BILH'S TAX - EXEMPT AFFILIATE NORTHEAST BEHAVIORAL HEALTH CORP) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS. BILHBS' NETWORK OF BEHAVIORAL HEALTH CARE INCLUDES SERVICES FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TREATMENT TO COMMUNITY - BASED PROGRAMS. SERVICES INCLUDE: INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; EMERGENCY PSYCHIATRIC AND MOBILE EMERGENCY SERVICES TEAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION TREATMENT; INDIVIDUAL/COUPLE/FAMILY THERAPY; MEDICATION ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS; AND SCHOOL - BASED AND HOME - BASED COUNSELING FOR YOUTH AND THEIR FAMILIES.SINCE THE CREATION OF BILH IN MARCH 2019, BILH HAS INVESTED SIGNIFICANTLY IN IMPROVING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH A SYSTEM - WIDE APPROACH TO CARE DELIVERY. FIRST, IT HAS MADE A MULTI - YEAR COMMITMENT TO PROVIDE BEHAVIORAL HEALTH SUPPORT TO ITS EMPLOYED PRIMARY CARE PRACTICES USING AN EVIDENCE - BASED APPROACH KNOWN AS THE IMPACT MODEL. BY THE END OF FY 2021, BILH HAD IMPLEMENTED THE IMPACT MODEL IN 67% OF ITS EMPLOYED PRIMARY CARE PRACTICES AS PART OF ITS COLLABORATIVE CARE PROGRAM IMPLEMENTATION. IN 2021, BILHBS EXPANDED ITS PRIMARY CARE BEHAVIORAL HEALTH INTEGRATION (PCBHI) SERVICES BY INCORPORATING A DSRIP PILOT PROJECT AIMED AT INTERPROFESSIONAL PSYCHIATRIC CONSULTS. THE PCBHI INTERPROFESSIONAL CONSULTATION INCLUDES AN ASSESSMENT AND MANAGEMENT SERVICE IN WHICH A PATIENT'S PRIMARY CARE PROVIDER (PCP) REQUESTS THE OPINION AND/OR TREATMENT ADVICE OF A PSYCHIATRIC CONSULTANT TO ASSIST IN THE DIAGNOSIS AND/OR MANAGEMENT OF THE PATIENT'S BEHAVIORAL HEALTH CONDITION WITHOUT THE NEED FOR THE PATIENT'S FACE - TO - FACE CONTACT WITH THE CONSULTANT. INTERPROFESSIONAL CONSULTATION ENABLES A COMPREHENSIVE ASSESSMENT, ENHANCES PATIENT CARE, REDUCES MISDIAGNOSIS, AND SUPPORTS THE INTEGRATION OF DISCIPLINES IN THE DELIVERY OF CARE. THE PCBHI INTERPROFESSIONAL PSYCHIATRIC CONSULTANTS PROVIDE PCPS WITH ANOTHER AVENUE FOR INTEGRATED CARE. THE IMPLEMENTATION OF PCBHI INTERPROFESSIONAL SERVICES WILL BE OFFERED IN PRACTICES WHERE COLLABORATIVE CARE IS NOT CURRENTLY AVAILABLE. ADDITIONALLY, IN 2021, BILHBS CONTINUED TO OVERSEE THE BILH - WIDE CENTRALIZED BEHAVIORAL HEALTH (BH) BED MANAGEMENT, WHICH SUPPORTS INPATIENT BEHAVIORAL HEALTH BED CAPACITY AND IMPROVING ACCESS TO THESE BEDS, WITH THE PARALLEL GOAL OF REDUCING BOARDING BY BEHAVIORAL HEALTH PATIENTS IN THE EMERGENCY DEPARTMENTS (""EDS""). AS PART OF THE CENTRALIZED BH BED MANAGEMENT, BILH STAFF ENGAGE IN A DAILY HUDDLE WITH REPRESENTATIVES FROM BILH HOSPITALS' EDS AND BEHAVIORAL HEALTH UNITS TO DISCUSS PATIENTS APPROPRIATE FOR TRANSFER TO THE UNIT. THE DAILY HUDDLES HAVE BECOME A FORUM FOR WHICH PARTICIPANTS DISCUSS BEHAVIORAL HEALTH PATIENT VOLUME AND BED CAPACITY ACROSS THE SYSTEM, AS WELL AS DISCHARGE PLANNING AND PLACEMENT OPPORTUNITIES FOR DIFFICULT - TO - PLACE PATIENTS.SEPARATELY, IN MARCH 2021, BILHBS LAUNCHED ITS CENTRALIZED BED FINDING TEAM. THIS TEAM IS PART OF OUR CENTRAL CALL CENTER, WHICH CENTRALIZES CALLS TO BILHBS' THREE EMERGENCY SERVICE PROGRAM (ESP) CATCHMENT AREAS REDUCING REDUNDANCIES ACROSS THE AGENCY AND STREAMLINING ALL CALLS TO ONE CENTRAL SERVICE. THIS CENTRALIZED BED FINDING TEAM IS RESPONSIBLE FOR CONDUCTING BED SEARCHES FOR PATIENTS SEEN THROUGH THE ESP AND WHO ARE AWAITING AN INPATIENT PSYCHIATRIC PLACEMENT. THIS TEAM DIRECTLY INCREASES THE AVAILABILITY OF CLINICIANS TO CONTINUE TO SEE PATIENTS IN THE ED AND THE COMMUNITY WHO ARE EXPERIENCING A BEHAVIORAL HEALTH AND/OR CO - OCCURRING SUBSTANCE USE DISORDER CRISIS WHILE OTHER TEAM MEMBERS SEARCH FOR AVAILABLE INPATIENT PLACEMENTS. THIS INITIATIVE SUPPORTS DECREASED RESPONSE TIME TO RESPONDING TO NEW PATIENTS IN CRISIS AND REDUCES ED BOARDING TIME FOR PATIENTS WHO CAN BE SAFELY MANAGED IN THE COMMUNITY.BILHBS SERVES APPROXIMATELY 35,000 UNDUPLICATED INDIVIDUALS ANNUALLY, OFFERING A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS. SERVICES RANGE FROM INPATIENT TO HOME AND COMMUNITY - BASED SERVICES. BILHBS OPERATES OVER 250 BEDS IN 9 FACILITIES FOR CLIENTS REQUIRING ACUTE PSYCHIATRIC CARE, DETOXIFICATION AND RESIDENTIAL STEP - DOWN SERVICES. DURING THE PERIOD COVERED BY THIS FILING, COMMUNITY - BASED SERVICES INCLUDED MOBILE EMERGENCY SERVICES TEAMS IN THREE CATCHMENT AREAS AND HOME - BASED COUNSELING FOR ADULTS, YOUTH AND THEIR FAMILIES. BILHBS ALSO PROVIDED SERVICES IN 63 MIDDLE AND HIGH SCHOOLS, AS WELL AS 9 POLICE DEPARTMENTS.BILHBS ALSO CONTINUES TO IMPROVE ACCESS THROUGH THE URGENT PSYCHOPHARMACOLOGY SERVICES IN BILH'S LOWELL EMERGENCY SERVICES PROGRAM. THIS CLINIC PROVIDES URGENT ACCESS FOR PATIENTS REQUIRING A CHANGE TO THEIR MEDICATIONS. THIS SERVICE IS OFFERED 20 HOURS PER WEEK AND INCLUDES UNINSURED, MEDICAID, AND MEDICARE POPULATIONS, AS WELL AS ANY PERSON IN NEED OF THE SERVICE REGARDLESS OF THE PAYER SOURCE. BILH'S COMMUNITY CRISIS STABILIZATION (""CCS"") UNITS IN LAWRENCE AND SALEM, WHICH TYPICALLY CARE FOR PATIENTS WITH MENTAL HEALTH ISSUES, INCREASED THEIR ABILITY TO TREAT PERSONS WITH CO - OCCURRING SUBSTANCE USE DISORDERS. THE CCS UNITS CONTINUE TO BE ABLE TO INDUCT PATIENTS WITH OPIOID USE DISORDER (OUD) ON BUPRENORPHINE AND ARE ALSO ABLE TO MAINTAIN PATIENTS WHO ARE ALREADY ON ANY OF THE THREE FDA APPROVED MEDICATIONS FOR THE TREATMENT OF OUD. THESE UNITS ARE SEEING AN INCREASE IN THE NUMBER OF PATIENTS WITH METHAMPHETAMINE DISORDERS AND HAVE DEVELOPED A PROTOCOL TO MANAGE WITHDRAWAL SYMPTOMS IN THIS POPULATION.BILHBS CONTINUES TO MAINTAIN AND ENHANCE ITS TELEHEALTH PLATFORM AND CLINICAL DELIVERY THROUGH THE USE OF DIGITAL APPLICATIONS ACROSS ALL OF ITS AMBULATORY PROGRAMS. SPECIAL EMPHASIS WAS PLACED ON SPANISH - LANGUAGE ACCESS TO LAWRENCE - BASED PROGRAMS TO ENSURE PATIENTS IN THIS REGION ACCESS LINGUISTICALLY - APPROPRIATE CARE. IN 2021, BILHBS IDENTIFIED IMPROVEMENT OF THE PATIENT EXPERIENCE AS A KEY STRATEGIC PRIORITY. TO THAT END, ALL PROGRAM DIRECTORS ARE EVALUATED AGAINST THIS GOAL AND ARE REQUIRED TO COMPLETE TWO PLAN - DO - STUDY - ACT (PDSA) CYCLES ANNUALLY. PDSA IS A WELL - ESTABLISHED PROCESS IMPROVEMENT FRAMEWORK USED IN HEALTHCARE. PROGRAM DIRECTORS REVIEW PATIENT FEEDBACK TO DEVELOP PILOT INTERVENTIONS, ANALYZE THE RESULTS, AND THEN MAKE ADJUSTMENTS TO THE INTERVENTION. EXAMPLES OF OUTCOMES ACHIEVED THROUGH THE PDSA APPROACH INCLUDE ENHANCING THE PATIENT ENGAGEMENT MODEL FOR THE BEHAVIORAL HEALTH COMMUNITY PARTNERS (BHCP) PROGRAM; IMPROVING PATIENT EXPERIENCES AND ENGAGEMENT IN THE USE OF TELEHEALTH PLATFORMS IN BILHBS' LAWRENCE OUTPATIENT SITE, IMPROVING THE ADMISSION PROCESS IN THE BILHBS GLOUCESTER OPIOID TREATMENT CENTER, REDUCING ADMINISTRATIVE DISCHARGES BY IMPLEMENTING A HARM REDUCTION MODEL, AND IMPROVING EXTERNAL REFERRAL EXPERIENCE AT THE BILHBS HAVERHILL OUTPATIENT AND CHILDREN'S BEHAVIORAL HEALTH INITIATIVES (CBHI) PROGRAMS."